Murray D W, Pandit H, Weston-Simons J S, Jenkins C, Gill H S, Lombardi A V, Dodd C A F, Berend K R
The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK; The Nuffield Orthopaedic Centre, Headington, Oxford, UK.
Knee. 2013 Dec;20(6):461-5. doi: 10.1016/j.knee.2012.09.017. Epub 2012 Oct 27.
Obesity is considered to be a contraindication for unicompartmental knee replacement (UKR). The aim was to study the impact of BMI on failure rate and clinical outcome of the Oxford mobile bearing UKR.
Two thousand four hundred and thirty-eight medial Oxford UKRs were studied prospectively and divided into groups: BMI<25 (n=378), BMI 25 to <30 (n=856), BMI 30 to <35 (n=712), BMI 35 to <40 (n=286), and BMI 40 to <45 (n=126) and BMI≥45 (n=80).
There was no significant difference in survival rate between groups. At a mean follow-up of 5years (range 1-12years) there was no significant difference in the Objective American Knee Society Score between groups. There was a significant (p<0.01) trend with the Oxford Knee Score (OKS) and Functional American Knee Society Scores decreasing with increasing BMI. As there was an opposite trend (p<0.01) in pre-operative OKS, the change in OKS increased with increasing BMI (p=0.048). The mean age at surgery was significantly (p<0.01) lower in patients with higher BMI.
Increasing BMI was not associated with an increasing failure rate. It was also not associated with a decreasing benefit from the operation. Therefore, a high BMI should not be considered a contra-indication to mobile bearing UKR.
IV.
肥胖被认为是单髁膝关节置换术（UKR）的禁忌证。本研究旨在探讨体重指数（BMI）对牛津活动平台UKR失败率及临床疗效的影响。
对2438例接受内侧牛津UKR的患者进行前瞻性研究，并将其分为以下几组：BMI<25（n=378）、BMI 25至<30（n=856）、BMI 30至<35（n=712）、BMI 35至<40（n=286）、BMI 40至<45（n=126）以及BMI≥45（n=80）。
各组之间的生存率无显著差异。平均随访5年（范围1 - 12年），各组之间美国膝关节协会客观评分无显著差异。牛津膝关节评分（OKS）和美国膝关节协会功能评分随BMI增加呈显著（p<0.01）下降趋势。由于术前OKS呈相反趋势（p<0.01），OKS的变化随BMI增加而增大（p=0.048）。BMI较高的患者手术时的平均年龄显著更低（p<0.01）。
BMI增加与失败率升高无关，也与手术获益减少无关。因此，高BMI不应被视为活动平台UKR的禁忌证。
IV级
