经股内侧肌间隙入路治疗膝关节骨性关节炎的临床疗效观察

Clinical Observation of Knee Joint Osteoarthritis through the Medial Femoral Muscle Space Approach

摘要: 目的：对比经股内侧肌间隙入路及内侧髌旁入路进行膝关节置换术的临床疗效。方法：在我们研究中，采用经股内侧肌间隙入路及内侧髌旁入路进行膝关节置换术，分别对比手术时间、切口长度、出血量及住院时间，同时观察了术后不同时间膝关节ROM度数及HSS评分结果。结果：我们发现两种手术方式在手术时间、切口长度及住院时间方面没有差异性，然而具有更少的出血量。此外，我们进一步观察了膝关节ROM度数及HSS评分结果，发现在术后6 h及1 d，经股内侧肌间隙手术入路行手术患者具有更高的ROM度数及HSS评分，而在其他时间点两种手术方式结果没有差异性。结论：经股内侧肌间隙入路行膝关节置换术具有出血少和短期膝关节较好的功能恢复及较低的疼痛感觉，为患者远期的功能恢复提供一个良好的开端，减少贫血的发生率，建立术后锻炼的信心，加快功能恢复，改善生活质量，具有良好的社会及经济利益，值得应用及推广。

Abstract: Objective: To compare the clinical effect of knee arthroplasty with medial femoral muscle space approach and medial paracondylar approach. Methods: In our study, knee replacement was per-formed using the medial femoral muscle space approach and the medial paracondylar approach. The surgical time, incision length, bleeding volume, and length of hospital stay were compared, and the ROM degree and HSS score results of knee joints were observed at different times after surgery. Results: We found that there was no difference in surgical time, incision length, and length of hospital stay (p > 0.05), but there was less bleeding compared to the medial paracondylar approach (p < 0.05). In addition, we further observed the ROM and HSS scores of knee joints, and found that patients who underwent surgery through the medial femoral space surgery had higher ROM scores and HSS scores at 6 h and 1 d (p < 0.05), and there was no difference at other time points in the results of this surgical approach (p > 0.05). Conclusions: The knee arthroplasty via the medial femoral muscle space approach has less bleeding and better functional recovery and lower pain in the early postoperative period, which provides a good start for patients with long-term functional recovery, reduces the incidence of anemia, establishes confidence in postoperative exercise, speeds up functional recovery, improves quality of life, has good social and economic benefits, and is worthy of application and promotion.