目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．