Department of Orthopaedic Surgery, Eulji University College of Medicine, Seo-gu, Daejeon, Korea.
Clin Orthop Surg. 2011 Sep;3(3):178-83. doi: 10.4055/cios.2011.3.3.178. Epub 2011 Aug 19.
This study examined the clinical and radiologic mid-term results of patients treated by Oxford minimally invasive unicompartmental knee arthroplasty.
One hundred and eighty-eight knees of unicompartmental knee arthroplasties with Oxford Uni® in 166 patients (16 males and 150 females), which were performed between 2002 and 2005, were reviewed. The mean age was 65.3 years (range, 44 to 82 years) and the mean follow-up period was 79.8 months (range, 56 to 103 months). The preoperative diagnosis was osteoarthritis in 166 patients, osteonecrosis of the medial femoral condyle in 20 and chondrocalcinosis in 2.
The mean Hospital for Special Surgery (HSS) knee score was 67.5 (range, 52 to 75) preoperatively and 89.9 (range, 85 to 100) at the final follow-up. The mean preoperative flexion contracture was 6.5° (range, 0 to 15°) and 0.8° (range, 0 to 5°) at the final follow-up. The mean full flexion increased from 135° (range, 90 to 150°) preoperatively to 150° (range, 140 to 165°) at the final follow-up. Active full flexion was possible within 2 postoperative months. The squatting and cross-leg postures were possible in 133 patients (80.1%) and 152 patients (91.6%) at the final follow-up. The mean tibiofemoral angle was improved from varus 1.5° to valgus 4.8°. Complications were encountered in 18 cases (9.5%). A bearing dislocation occurred in 10 cases (5.3%), tibial component loosening in 4 cases (2.1%), femoral loosening in 3 cases (1.6%) and lateral translation in 1 case (0.5%). The mean time for a bearing dislocation was 22.6 months (range, 3 to 70 months) postoperatively. Seven cases returned to the predislocation level of activity with the insertion of a thicker bearing and 3 cases converted to total knee arthroplasty.
Minimally invasive unicompartmental knee arthroplasty with Oxford Uni® provided rapid recovery, good pain relief and excellent function suitable for the Korean lifestyle. In contrast, the high complication rates of Oxford Uni® encountered in the mid-term results suggested less reliability than total knee arthroplasty.
本研究旨在评估牛津微创单髁膝关节置换术治疗患者的临床和影像学中期结果。
对 2002 年至 2005 年间进行的 166 例患者（16 名男性和 150 名女性）188 例牛津 Uni®单髁膝关节置换术的膝关节进行回顾性分析。患者平均年龄为 65.3 岁（44 至 82 岁），平均随访时间为 79.8 个月（56 至 103 个月）。术前诊断为骨关节炎 166 例，内侧股骨髁骨坏死 20 例，软骨钙质沉着症 2 例。
术前美国特种外科医院（HSS）膝关节评分平均为 67.5（52 至 75），末次随访时为 89.9（85 至 100）。术前平均屈曲挛缩为 6.5°（0 至 15°），末次随访时为 0.8°（0 至 5°）。术后 2 个月内可进行全膝关节主动屈曲，术前平均完全屈曲 135°（90 至 150°），末次随访时为 150°（140 至 165°）。133 例（80.1%）和 152 例（91.6%）患者在末次随访时可完成深蹲和跷二郎腿动作。胫骨股骨角从内翻 1.5°改善为外翻 4.8°。18 例（9.5%）出现并发症。10 例（5.3%）发生关节脱位，4 例（2.1%）胫骨组件松动，3 例（1.6%）股骨松动，1 例（0.5%）外侧平移。关节脱位的平均时间为术后 22.6 个月（3 至 70 个月）。7 例通过插入更厚的衬垫使关节回到脱位前的活动水平，3 例转换为全膝关节置换术。
牛津微创单髁膝关节置换术可使患者快速康复，缓解疼痛，获得良好的膝关节功能，非常适合韩国人的生活方式。相比之下，牛津 Uni®在中期结果中出现的高并发症率表明其可靠性不如全膝关节置换术。
