Heyse Thomas J, Khefacha Ahmed, Peersman Geert, Cartier Philippe
Department of Orthopedics and Rheumatology, University Hospital Marburg, Germany.
Knee. 2012 Oct;19(5):585-91. doi: 10.1016/j.knee.2011.09.002. Epub 2011 Oct 1.
Unicompartmental knee arthroplasty (UKA) is known to be a viable procedure allowing for preservation of the intact compartments and delivering excellent function at long-term follow-up. The primary purpose of this single-surgeon study was to analyse the survivorship of a fixed bearing UKA in patients younger than 60 years.
From all UKAs implanted between 1993 and 2005 at the senior authors' centre, 223 patients <60 years at operation with a minimum follow-up of 5 years were identified including all-poly and metal-backed tibiae. They were evaluated applying the Knee Society Score (KSS) at latest follow-up. Survivorship was calculated using Kaplan-Meier analysis, which considered the following variables: gender, type of tibial implant, medial vs. lateral UKA, and age.
Average age at index operation was mean 53.7 (SD 5.8, range 30-60) years at a mean follow-up of 10.8 (SD 3.5, range 5-17) years. From the KSS, the knee score was 94.3 (SD 7.8) and the function score was 94.9 (SD 6.8). At latest follow-up, the implant survival rate was 94.3%. Survivorship for the entire cohort was 93.5% at 10 years (medial UKA 94.1% vs. lateral 91.8%), and 86.3% at 15 years (85.1% medial vs. 91.7% lateral)
In conclusion, excellent survival and function outcomes were noted in this subgroup of patients younger than 60 years. Revision rates were comparable to those studies in which UKA was performed on an elderly patient population. UKA can successfully be performed in patients younger than 60 years with appropriate patient selection.
单髁膝关节置换术（UKA）是一种可行的手术，能够保留完整的关节间室，并在长期随访中提供出色的功能。这项单术者研究的主要目的是分析60岁以下患者接受固定平台UKA的假体生存率。
在资深作者所在中心于1993年至2005年间植入的所有UKA中，确定了223例手术时年龄小于60岁且至少随访5年的患者，包括全聚乙烯和金属背衬胫骨假体。在最近一次随访时应用膝关节协会评分（KSS）对他们进行评估。使用Kaplan-Meier分析计算假体生存率，该分析考虑了以下变量：性别、胫骨假体类型、内侧与外侧UKA以及年龄。
初次手术时的平均年龄为53.7（标准差5.8，范围30 - 60）岁，平均随访时间为10.8（标准差3.5，范围5 - 17）年。根据KSS，膝关节评分为94.3（标准差7.8），功能评分为94.9（标准差6.8）。在最近一次随访时，假体生存率为94.3%。整个队列在10年时的假体生存率为93.5%（内侧UKA为94.1%，外侧为91.8%），在15年时为86.3%（内侧为85.1%，外侧为91.7%）。
总之，在这个60岁以下的患者亚组中观察到了出色的生存和功能结果。翻修率与在老年患者群体中进行UKA的研究相当。通过适当的患者选择，UKA可以成功地在60岁以下的患者中进行。
