Manzotti A, Confalonieri N, Pullen C
Ist Orthopaedic Department, Centro Traumatologico ed Ortopedico (C.T.O.) - I.C.P., Via Bignami 1, Milan, Italy.
Int Orthop. 2007 Jun;31(3):315-9. doi: 10.1007/s00264-006-0184-x. Epub 2006 Aug 2.
Patients older than 60 with unicompartmental knee arthritis can be treated with total or unicompartmental knee replacement. The aim of this study was to compare the results of matched paired groups of patients with isolated medial compartment knee arthritis replaced with either UKR (group A) or computer-assisted TKR (group B). The results included 68 knees at a minimum follow-up of 3 years. All patients had a varus deformity no greater than 8 masculine and a BMI lower than 30. Patients were matched in terms of preoperative arthritis severity, age, gender and preoperative range of motion. In the computer-assisted TKR group, all the implants were positioned within 4 masculine of the correct hip-knee-ankle angle and frontal tibial component angle. The surgical time and hospital stay were statistically longer in the CA TKR group. During the study no implant required revision. The results showed higher scores for a UKR in the treatment of isolated primary unicompartmental knee arthritis in patients older than 60 compared to a computer-assisted TKR. In this study a computer-assisted alignment system for TKR with optimal implant positioning did not produce equivalent clinical results compared to a UKR, but did increase the financial costs.
60岁以上的单间室膝关节关节炎患者可采用全膝关节置换术或单间室膝关节置换术进行治疗。本研究的目的是比较单纯内侧间室膝关节关节炎患者配对组分别接受单髁膝关节置换术(A组)或计算机辅助全膝关节置换术(B组)的结果。结果纳入了68个膝关节,至少随访3年。所有患者内翻畸形不超过8°,体重指数低于30。患者在术前关节炎严重程度、年龄、性别和术前活动范围方面进行了匹配。在计算机辅助全膝关节置换术组中,所有植入物的位置与正确的髋-膝-踝角和胫骨假体额状面角度相差不超过4°。计算机辅助全膝关节置换术组的手术时间和住院时间在统计学上更长。在研究期间,没有植入物需要翻修。结果显示,与计算机辅助全膝关节置换术相比,单髁膝关节置换术在治疗60岁以上单纯原发性单间室膝关节关节炎患者时得分更高。在本研究中,具有最佳植入物定位的计算机辅助全膝关节置换术对准系统与单髁膝关节置换术相比,并未产生等效的临床结果,但确实增加了经济成本。