Dalury David, Kelley Todd C, Adams Mary Jo
Towson Orthopaedic Associates, Towson, MD, USA.
J Knee Surg. 2013 Apr;26(2):133-7. doi: 10.1055/s-0032-1322599. Epub 2012 Jul 30.
In middle-aged patients with knee arthritis, surgical treatment options include arthroscopic procedures, osteotomies, and unicompartmental and total knee arthroplasty. Unicompartmental knee osteoarthrosis is particularly challenging and controversial in such patients. From December 2001 through October 2005, we treated 32 consecutive middle-aged patients (46 to 59 years old) with 40 medial unicompartmental knee arthroplasties. Three patients were lost to follow-up, leaving 29 for our study. There were two reoperations: one for loosening at 3 years, and one for disease progression at 5 years. Implant survival was modeled using Kaplan-Meier survival function with observations censored if lost to follow-up. At the 6-year survivorship in this group, the overall implant survival rate was 94.1% (95% CI, 78.3-98.5). Knee Society scores had improved significantly (p < 0.001). There were no other instances of osteolysis or radiographic failure. We concluded that, at mid-term follow-up, unicompartmental knee arthroplasty provided satisfactory results for this challenging population.
在中年膝关节炎患者中，手术治疗选择包括关节镜手术、截骨术以及单髁和全膝关节置换术。单髁膝关节骨关节炎在这类患者中尤其具有挑战性且存在争议。从2001年12月至2005年10月，我们连续治疗了32例中年患者（46至59岁），共进行了40例内侧单髁膝关节置换术。3例患者失访，剩余29例纳入我们的研究。有2例再次手术：1例在3年时因假体松动，1例在5年时因病情进展。使用Kaplan-Meier生存函数对植入物存活率进行建模，若失访则对观察值进行截尾处理。在该组6年的生存率中，总体植入物存活率为94.1%（95%可信区间，78.3 - 98.5）。膝关节协会评分有显著改善（p < 0.001）。没有其他骨溶解或影像学失败的情况。我们得出结论，在中期随访中，单髁膝关节置换术为这一具有挑战性的人群提供了满意的结果。
