Price A J, Waite J C, Svard U
Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford OX13 5LS, UK.
Clin Orthop Relat Res. 2005 Jun(435):171-80. doi: 10.1097/00003086-200506000-00024.
The medial Oxford unicompartmental knee arthroplasty uses a fully congruent mobile bearing, varying in thickness from 3.5-11.5 mm. Impressive clinical and survival results have been achieved by the designing surgeon, but can they be reproduced by an independent center and does the use of bearings less than 6 mm thick reduce the implant's survival? Between November 1983 and May 2000, 439 medial Oxford prostheses were implanted by three surgeons in Skovde, Sweden. One hundred fourteen knees (89 patients) were reviewed clinically at a minimum of 10 years postoperatively, using the Hospital for Special Surgery knee score. Ninety-one percent of the knees had good or excellent results, with no poor results, and 82% were reported as pain free. The 15-year survival rate for the entire cohort was 93%, and for the 432 knees (344 patients) that met the current indications for using the device, the survival rate was 94%. The 10-year survival rate for bearings less than 6 mm thick was 95%, compared with 94% with bearings greater than 6 mm. The results show that an independent center can achieve excellent long-term clinical and survival results in patients implanted with the Oxford prosthesis. Survival of the implant was not reduced by the use of thin polyethylene bearings.
Therapeutic study, Level IV (case series--no, or historical, control group). See the Guidelines for Authors for a complete description of levels of evidence.
牛津内侧单髁膝关节置换术采用完全匹配的活动衬垫，厚度在3.5至11.5毫米之间变化。设计该手术的外科医生取得了令人瞩目的临床和生存率结果，但独立中心能否重现这些结果，使用厚度小于6毫米的衬垫是否会降低植入物的生存率呢？在1983年11月至2000年5月期间，瑞典斯科夫德的三位外科医生植入了439个牛津内侧假体。对114个膝关节（89名患者）进行了术后至少10年的临床复查，采用特种外科医院膝关节评分。91%的膝关节结果为良好或优秀，无不良结果，82%的患者报告无疼痛。整个队列的15年生存率为93%，对于符合当前使用该装置指征的432个膝关节（344名患者），生存率为94%。厚度小于6毫米的衬垫的10年生存率为95%，而厚度大于6毫米的衬垫为94%。结果表明，独立中心在植入牛津假体的患者中可以取得出色的长期临床和生存率结果。使用薄聚乙烯衬垫不会降低植入物的生存率。
治疗性研究，IV级（病例系列——无或历史性对照组）。有关证据水平的完整描述，请参阅作者指南。
