Comparison of total knee arthroplasty and unicompartmental knee arthroplasty in treatment of traumatic osteoarthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: The incidence of traumatic osteoarthritis is increasing in recent years. At present, total knee arthroplasty and unicondylar arthroplasty are commonly used in clinical treatment, and their therapeutic effects still need to be verified. OBJECTIVE: To compare effects between total knee arthroplasty and unicompartmental knee arthroplasty on the patients with traumatic knee osteoarthritiss. METHODS: A total of 102 patients with bilateral traumatic osteoarthritis were treated in the Affiliated Hospital of Qingdao University between January 2016 and June 2018. The patients were divided into total knee arthroplasty group and unicompartmental knee arthroplasty group (n=51 for each group). Operation indexes (operation time, intraoperative blood loss, decrease of hemoglobin 48 hours after operation, proportion of patients receiving blood transfusion during perioperative period, total length of stay and hospitalization cost) were compared between the two groups. Visual analogue scale score, American knee society knee score, and The Western Ontario and McMaster Universities osteoarthritis index were compared before surgery and 2 weeks, 3 and 6 months after surgery. The postoperative complications and subjective satisfaction after 6 months of follow-up were compared between the two groups. RESULTS AND CONCLUSION: (1) Operation time, intraoperative blood loss and decrease in hemoglobin at 48 hours after surgery were significantly lower in the unicompartmental knee arthroplasty group than those in the total knee arthroplasty group. The proportion of blood transfusion during perioperative period was significantly lower in the unicompartmental knee arthroplasty group than that in the total knee arthroplasty group. Total length of stay and hospitalization cost were significantly less in the unicompartmental knee arthroplasty group than those in the total knee arthroplasty group (P 0.05). Compared with those before surgery, visual analogue scale score and American knee society knee score were significantly lower; and The Western Ontario and McMaster Universities osteoarthritis index was significantly higher in both groups at 2 weeks, 3 and 6 months after surgery (P < 0.05). Visual analogue scale score, American knee society knee score, and The Western Ontario and McMaster Universities osteoarthritis index were significantly better in the unicompartmental knee arthroplasty group than those in the total knee arthroplasty group at various time points after surgery (P < 0.05). (3) During the 6-month follow-up, subjective satisfaction was significantly higher in the unicompartmental knee arthroplasty group than that in the total knee arthroplasty group (P < 0.05). (4) Complications In the total knee arthroplasty group, there were 3 cases of postoperative infection and 2 cases of deep vein thrombosis, and the total incidence of postoperative complications was 10%. In the unicompartmental knee arthroplasty group, there was 1 case of postoperative infection, and the total incidence of postoperative complications was 2%. The incidence of postoperative complications in unicompartmental knee arthroplasty group was lower than that in total knee arthroplasty group, but the difference was not statistically significant (P < 0.05). (5) Unicompartmental knee arthroplasty in treatment of traumatic knee osteoarthritis has obvious advantages, can reduce length of stay and hospitalization cost, and patients have high satisfaction after operation. Unicompartmental knee arthroplasty is beneficial to the postoperative recovery of patients, and can be used as the first choice for clinical treatment of traumatic osteoarthritis.