关节镜探查联合单髁置换术对膝关节骨性关节炎患者膝关节功能的影响

doi:10.11958/20251325

天津医药 ›› 2025, Vol. 53 ›› Issue (7): 725-729.doi: 10.11958/20251325

关节镜探查联合单髁置换术对膝关节骨性关节炎患者膝关节功能的影响

何仁豪(), 张聘, 尹识渊, 张杰^△()

宿迁市第一人民医院骨科（邮编223800）

收稿日期:2025-03-31 修回日期:2025-05-06 出版日期:2025-07-15 发布日期:2025-07-21
通讯作者: ^△E-mail：676489322@qq.com
作者简介:何仁豪（1985），男，副主任医师，主要从事运动医学与关节方面研究。E-mail：824472686@qq.com
基金资助:
宿迁市科技项目(K202356)

Effects of arthroscopic exploration combined with unicompartmental replacement surgery on knee joint function in patients with knee osteoarthritis

HE Renhao(), ZHANG Pin, YIN Shiyuan, ZHANG Jie^△()

Department of Orthopedics, Suqian First People's Hospital, Suqian 223800, China

Received:2025-03-31 Revised:2025-05-06 Published:2025-07-15 Online:2025-07-21
Contact: ^△E-mail：676489322@qq.com

何仁豪, 张聘, 尹识渊, 张杰. 关节镜探查联合单髁置换术对膝关节骨性关节炎患者膝关节功能的影响[J]. 天津医药, 2025, 53(7): 725-729.

HE Renhao, ZHANG Pin, YIN Shiyuan, ZHANG Jie. Effects of arthroscopic exploration combined with unicompartmental replacement surgery on knee joint function in patients with knee osteoarthritis[J]. Tianjin Medical Journal, 2025, 53(7): 725-729.

摘要/Abstract

摘要：

目的探究关节镜探查联合单髁置换术对膝关节骨性关节炎患者膝关节功能的影响。方法选取2021年8月—2024年2月就诊的82例膝关节骨性关节炎患者，随机分为对照组和观察组，各41例。采用单盲设计，均先给予常规治疗，对照组给予单髁置换术，观察组给予关节镜探查联合单髁置换术，比较2组手术前后在膝关节评分标准（HSS）、匹兹堡睡眠质量指数（PSQI）、疼痛视觉模拟量表（VAS）评分、生活质量、血清超氧化物歧化酶（SOD）、丙二醛（MDA）和膝关节活动度等方面的差异。结果治疗后，2组HSS评分、社会功能、躯体功能、总体健康评分、SOD、膝关节屈曲角度均升高（均P<0.05），观察组更高（t分别为3.821、4.027、3.706、3.957、7.481、3.733，均P<0.05）；2组PSQI评分、疼痛VAS评分、MDA、胫股角度均降低（均P<0.05），观察组更低（t分别为4.601、8.375、9.084、3.625，均P<0.05）。结论关节镜探查联合单髁置换术治疗膝关节骨性关节炎能有效改善患者膝关节功能，提高生活质量。

关键词: 骨关节炎, 膝, 关节镜检查, 生活质量, 膝关节功能, 单髁置换术

Abstract:

Objective To investigate the effect of arthroscopic exploration combined with unicompartmental replacement surgery on knee joint function in patients with knee osteoarthritis. Methods Totally 82 patients with knee osteoarthritis in our hospital from August 2021 to February 2024 were included and stochastically divided into the control group and the observed group, with 41 patients in each group. Using a single-blind design, both groups received routine treatment first, while the control group received unicompartmental replacement surgery. The observation group was treated with arthroscopic exploration combined with unicompartmental replacement. Knee joint scoring criteria (HSS), Pittsburgh Sleep Quality Index (PSQI), Visual Analog Scale (VAS) scores, quality of life, serum superoxide dismutase (SOD), malondialdehyde (MDA) and knee joint range of motion were compared between two groups. Results After treatment, HSS score, social function, physical function, overall health score, SOD and knee flexion angle increased in both groups (P<0.05), and the observed group was even higher (t=3.821, 4.027, 3.706, 3.957, 7.481 and 3.733, P<0.05). PSQI score, VAS score, MDA and tibiofemoral angle decreased in both groups, and the observed group was even lower (t=4.601, 8.375, 9.084 and 3.625, P<0.05). Conclusion Arthroscopic exploration combined with unicompartmental replacement surgery can effectively improve knee joint function and enhance the quality of life of patients with knee osteoarthritis.

Key words: osteoarthritis, knee, arthroscopy, quality of life, knee joint function, unicompartmental replacement surgery

中图分类号:

R684

图/表 6

参考文献 19

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组别	性别			年龄/岁
		男	女
对照组		19（46.34）	22（53.66）		68.12±6.93
观察组		17（41.46）	24（58.54）		67.34±6.84
χ²或t		0.198			0.513
组别	体质量指数/（kg/m²）			手术部位
组别	体质量指数/（kg/m²）			左侧		右侧
对照组	23.87±2.42			18（43.90）		23（56.10）
观察组	24.05±2.53			16（39.02）		25（60.98）
χ²或t	0.311			0.201

组别	性别			年龄/岁
		男	女
对照组		19（46.34）	22（53.66）		68.12±6.93
观察组		17（41.46）	24（58.54）		67.34±6.84
χ²或t		0.198			0.513
组别	体质量指数/（kg/m²）			手术部位
组别	体质量指数/（kg/m²）			左侧		右侧
对照组	23.87±2.42			18（43.90）		23（56.10）
观察组	24.05±2.53			16（39.02）		25（60.98）
χ²或t	0.311			0.201

组别	HSS评分			PSQI评分			疼痛VAS评分
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	53.78±9.23	81.27±9.67	13.370^＊＊	14.51±3.14	7.68±1.35	12.926^＊＊	5.88±1.12	2.29±0.64	16.238^＊＊
观察组	52.29±8.57	89.68±10.26	16.193^＊＊	15.27±3.54	6.37±1.24	15.322^＊＊	6.37±1.41	1.27±0.45	20.281^＊＊
t	0.757	3.821^＊＊		1.024	4.601^＊＊		1.733	8.375^＊＊

组别	HSS评分			PSQI评分			疼痛VAS评分
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	53.78±9.23	81.27±9.67	13.370^＊＊	14.51±3.14	7.68±1.35	12.926^＊＊	5.88±1.12	2.29±0.64	16.238^＊＊
观察组	52.29±8.57	89.68±10.26	16.193^＊＊	15.27±3.54	6.37±1.24	15.322^＊＊	6.37±1.41	1.27±0.45	20.281^＊＊
t	0.757	3.821^＊＊		1.024	4.601^＊＊		1.733	8.375^＊＊

组别	社会功能			躯体功能			总体健康
组别	治疗前	治疗后	t	治疗前	治疗后	t	治疗前	治疗后	t
对照组	66.98±8.57	71.54±8.67	2.289^＊	73.54±10.24	78.51±8.68	2.339^＊	69.88±8.87	81.02±9.57	5.510^＊＊
观察组	65.37±7.65	79.68±9.62	7.178^＊＊	72.68±9.62	86.78±11.35	6.000^＊＊	68.59±8.52	89.68±10.24	12.069^＊＊
t	0.897	4.027^＊＊		0.389	3.706^＊＊		0.673	3.957^＊＊

关节镜探查联合单髁置换术对膝关节骨性关节炎患者膝关节功能的影响

Effects of arthroscopic exploration combined with unicompartmental replacement surgery on knee joint function in patients with knee osteoarthritis

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组别	SOD/（U/L）
组别	治疗前		治疗后			t
对照组	13.12±2.51		16.36±2.27			5.790^＊＊
观察组	12.24±2.16		20.35±2.54			14.163^＊＊
t	1.724		7.481^＊＊
组别		MDA/（nmol/L）
组别		治疗前		治疗后	t
对照组		6.06±1.13		4.68±0.87	5.900^＊＊
观察组		6.35±1.33		3.19±0.59	13.503^＊＊
t		1.068		9.084^＊＊

组别	SOD/（U/L）
组别	治疗前		治疗后			t
对照组	13.12±2.51		16.36±2.27			5.790^＊＊
观察组	12.24±2.16		20.35±2.54			14.163^＊＊
t	1.724		7.481^＊＊
组别		MDA/（nmol/L）
组别		治疗前		治疗后	t
对照组		6.06±1.13		4.68±0.87	5.900^＊＊
观察组		6.35±1.33		3.19±0.59	13.503^＊＊
t		1.068		9.084^＊＊

组别	膝关节屈曲角度
组别	治疗前		治疗后			t
对照组	88.69±10.85		109.49±13.52			7.362^＊＊
观察组	87.59±10.56		121.46±15.48			11.597^＊＊
t	0.461		3.733^＊＊
组别		胫股角度
组别		治疗前		治疗后	t
对照组		85.64±10.69		76.34±8.79	4.068^＊＊ 7.689^＊＊
观察组		86.38±11.32		69.51±8.23	4.068^＊＊ 7.689^＊＊
t		0.304		3.625^＊＊

组别	膝关节屈曲角度
组别	治疗前		治疗后			t
对照组	88.69±10.85		109.49±13.52			7.362^＊＊
观察组	87.59±10.56		121.46±15.48			11.597^＊＊
t	0.461		3.733^＊＊
组别		胫股角度
组别		治疗前		治疗后	t
对照组		85.64±10.69		76.34±8.79	4.068^＊＊ 7.689^＊＊
观察组		86.38±11.32		69.51±8.23	4.068^＊＊ 7.689^＊＊
t		0.304		3.625^＊＊