Siddiqui Nashat A, Ahmad Zafar M
Department of Trauma and Orthopaedics, Princess Alexandra Hospital, Brisbane, Queensland, QLD 4102, Australia.
Open Orthop J. 2012;6:268-75. doi: 10.2174/1874325001206010268. Epub 2012 Jul 27.
Isolated unicompartmental osteoarthritis in the young patient is a difficult problem to treat; they may be too young to consider total knee arthroplasty due to difficulties with inevitable future revision. Unicompartmental knee arthroplasty is one possible solution as it is perceived by some as being a smaller surgical insult than total knee arthroplasty, with easier revision to total knee arthroplasty than a revision total knee arthroplasty. A total knee arthroplasty performed as a revision unicondylar knee arthroplasty is thought by some authors to have equivalent functional outcomes to a primary total knee replacement.However, there have been several studies suggesting that revision is not as simple as suggested, and that function is not as good as primary total knee arthroplasty.We performed a systematic review of the literature regarding outcomes after revision of a unicondylar knee arthroplasty.Although there are many studies proposing selective use of the unicondylar knee arthroplasty, there are a number of studies highlighting difficulties with revision and poorer outcomes, and, therefore, the unicondylar knee arthroplasty cannot be considered a small procedure that will 'buy time' for the patient, and have results equal to a primary knee arthroplasty when revised. Further controlled studies, ideally randomised, are required before final conclusions can be drawn.
年轻患者的孤立性单髁骨关节炎是一个难以治疗的问题；由于未来不可避免的翻修困难，他们可能因年龄太小而不适合考虑全膝关节置换术。单髁膝关节置换术是一种可能的解决方案，因为有些人认为它比全膝关节置换术的手术创伤小，而且比起翻修全膝关节置换术，翻修为全膝关节置换术更容易。一些作者认为，作为翻修单髁膝关节置换术进行的全膝关节置换术与初次全膝关节置换术具有同等的功能结果。然而，有几项研究表明，翻修并不像所说的那么简单，而且功能也不如初次全膝关节置换术。我们对有关单髁膝关节置换术翻修后结果的文献进行了系统综述。尽管有许多研究建议选择性使用单髁膝关节置换术，但也有一些研究强调了翻修的困难和较差的结果，因此，单髁膝关节置换术不能被视为一种能为患者“争取时间”的小手术，并且在翻修时其结果等同于初次膝关节置换术。在得出最终结论之前，需要进一步的对照研究，理想情况下是随机对照研究。
