Aldinger P R, Walker T, Gotterbarm T
Orthopädische Klinik Paulinenhilfe, Diakonieklinikum Stuttgart, Rosenbergstraße 38, 70176, Stuttgart, Deutschland,
Orthopade. 2014 Oct;43(10):913-22. doi: 10.1007/s00132-014-3021-8.
Unicompartmental osteoarthritis of the knee joint affects the medial compartment more often than the lateral compartment whereby the lateral is solely affected in only 5-10 % of cases. In this case unicompartmental knee arthroplasty has been shown to be an effective alternative to total knee arthroplasty. There are some basic anatomical and biomechanical differences between the medial and lateral compartment of the knee joint which directly influence modern surgery techniques and implant design. In general, kinematics and design are fundamentally different in mobile-bearing compared to fixed-bearing prostheses.
This article presents a summary of outcome and survival rates after unicompartmental knee arthroplasty in the lateral compartment.
This article is based on a literature search in the PubMed database for clinical results after lateral unicompartmental knee arthroplasty.
The results demonstrate that lateral unicompartmental knee arthroplasty with a mobile-bearing implant and a domed tibial plateau design gives an excellent clinical outcome while reducing the dislocation rate to an acceptable level in the short and mid-term. Published data on the clinical outcome of fixed-bearing lateral unicompartmental knee arthroplasty prostheses revealed heterogeneous results due to the inclusion of different implant designs and relatively small patient cohorts. Nevertheless, most of them demonstrated good clinical results with a longer follow-up than current studies concerning mobile-bearing prostheses.
Based on the published data it is not possible to demonstrate precise differences in clinical outcome and survival rates after mobile-bearing and fixed-bearing unicompartmental knee arthroplasty or to make clear recommendations on the use of each type of prosthesis.
膝关节单髁骨关节炎累及内侧间室的情况比外侧间室更为常见,仅5%-10%的病例单纯累及外侧间室。在这种情况下,单髁膝关节置换术已被证明是全膝关节置换术的一种有效替代方法。膝关节内侧和外侧间室在解剖学和生物力学方面存在一些基本差异,这些差异直接影响现代手术技术和植入物设计。一般来说,活动平台假体与固定平台假体相比在运动学和设计上存在根本差异。
本文总结外侧间室单髁膝关节置换术后的疗效和生存率。
本文基于在PubMed数据库中检索外侧单髁膝关节置换术后的临床结果。
结果表明,采用活动平台植入物和圆顶胫骨平台设计的外侧单髁膝关节置换术在中短期内可取得优异的临床疗效,同时将脱位率降低至可接受水平。关于固定平台外侧单髁膝关节置换术假体临床疗效的已发表数据显示结果各异,这是由于纳入了不同的植入物设计和相对较小的患者队列。尽管如此,与目前关于活动平台假体的研究相比,大多数研究在更长的随访期内显示出良好的临床效果。
根据已发表的数据,无法证明活动平台和固定平台单髁膝关节置换术后在临床疗效和生存率方面存在精确差异,也无法就每种类型假体的使用提出明确建议。