中文摘要：

目的通过配对比较,对单髁置换术（UKA）及全膝置换术（TKA）早期的临床经济效益进行分析。方法 2010年1月至2013年12月期间,从上海市同济大学附属杨浦医院关节外科开展的TKA治疗患者中选取65例患者为TKA组,另从UKA治疗者中选取65例患者为UKA组,两组患者年龄、性别比、体重指数、随访时间严格配对。TKA组男性8例,女性57例;年龄60~80岁,平均（65±5）岁;体重52~79 kg,平均（65.9±6.0）kg;身体质量指数（BMI）平均（25.8±1.2）;左膝12例,右膝53例。UKA组男性10例,女性55例;年龄61~80岁,平均（65±5）岁;体重50~78 kg,平均（65.7±10.0）kg;BMI平均（25.6±1.3）;左膝15例,右膝50例。两组患者选择均符合如下条件：（1）屈曲畸形〈10°;（2）内翻畸形〈15°,摄应力或非应力X线片时可以矫正至中立位;（3）前交叉韧带通过体格检查或磁共振成像（MRI）检查证实完好无损;（4）膝关节侧位片显示前内侧关节间隙变窄,屈膝90°时显示后侧关节间隙正常（AlbackⅢ~Ⅳ期）;（5）正位片及CT显示外侧关节间隙正常,排除类风湿性关节炎及痛风性关节炎患者。上述患者均随访2年。采用SPSS 22.0统计软件进行统计对比分析,定量资料（平均年龄,体重指数,术前KSS膝评分,术后膝关节屈曲至90°所需时间,术后下地时间,住院天数,住院费,手术及假体费）通过非参数Mann-Whitney U检验进行比较。结果UKA组及TKA术组相比,术后患者膝关节屈曲达到90°所需的时间有统计学意义（Z=-9.9,P〈0.01）,术后下地时间有统计学意义（Z=-10.0,P〈0.01）,平均住院时间有统计学意义（Z=-9.7,P〈0.01）,术后康复时间有统计学意义（Z=-9.9,P〈0.01）,住院费用有统计学意义（Z=-9.7,P〈0.01）,平均手术费用有统计学意义（Z=10.1,P〈0.01）,术后康复费用有统计学意义（t=-9.9,P〈0.01）。UKA组与TKA组比较,出血量少、膝关节功能恢复快、住院时间短?

英文摘要：

Objective To analyse the cost-effectiveness of unicompartmental knee arthroplasty and total knee arthroplasty. Methods A comparison of hospitalization and rehabilitation costs was conducted between the two groups of patients who had the operations in the orthopedics department of Yangpu Hospital from January 2010 to December 2013. Sixty-five patients treated by total knee arthorplasty （TKA） were set as the TKA group, of which were eight males and 57 females, aged from 60-80 years with average age of （65 ± 5 ） years, and 12 cases of the left knee, 53 cases of the right knee. The range of weight was from 52- 79 kg with an average of （65.9±6. 0） kg, and the average body mass index （BMI） was （25.8 ± 1.2）. The other 65 patients were treated by minimally invasive unicompartental knee arthorplasty （UKA）, ofwhich were 10 males and 55 females, aged from 61-80 years with average age of （65 ±5） years, 15 cases of the left knee in and 50 cases of right knee. The range of weight was from 50-78 kg with an average of （65.7 ± 10. 0） kg, and the average BMI was （25.6± 1.3 ）. The age, sex ratio, body mass index, and follow-up time of the two groups were strictly matched. The two groups were selected according to the following criteria： （ 1 ） flexion deformity 〈 10° ; （2） varus〈 15°, knees on the stress or non stress X-ray films can be corrected to neutral position ; （3） the anterior cruciate ligament is confirmed intact by physical examination or magnetic resonance imaging （MRI） ; （4） on the knee radiographs, the medial is narrow, but when knee flexes to 90°, posterior joint space is normal （Alback m-lV ） ; （5） the anteroposterior X- ray and CT confirm normal joint space, without rheumatoid arthritis or gout arthritis. All the cases were followed up averagely for two years. A statistical comparison analysis between the two groups was conducted on different aspects by Mann-Whitney Utestusing SPSS 22.0： time of postoperative restoration of knee flexion