Iriberri Iker, Aragón José Francisco
Department of Orthopaedic Surgery, Centre Hospitalier de Saint Palais, Saint Palais, Pays Basque, France.
Department of Orthopaedic Surgery, Fundació Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain.
Knee. 2014 Dec;21(6):1269-74. doi: 10.1016/j.knee.2014.06.008. Epub 2014 Jul 8.
The ideal position of the unicompartmental knee arthroplasty (UKA) in the axial plane remains undefined the medical literature. The aim of this study was to observe how tibial components are placed in the axial plane and identify whether this could influence the postoperative clinical outcome.
A retrospective transversal study of 101 UKA was performed in 88 patients by a single surgeon. Postoperative CT scans were performed at a mean follow-up period of 71 months (36 to 150), and clinical and functional outcomes were assessed by the WOMAC and the KSS scores. Patients were divided several times in two groups depending on a different WOMAC or KSS value each time, and differences in axial angulation were analyzed in every comparison. Distribution of data and influence on outcomes were also analyzed.
The tibial component was positioned with a mean angulation of 11.9° (-1 to 32) of external rotation (ER). A lower angle of ER was observed in all comparisons in the groups with better outcomes. Differences between groups were statistically significant when a good result was defined as a WOMAC score lower than 10.
Variability in axial positioning (33°) is higher than in other planes due to the free-hand technique. A trend towards better outcomes is observed when the tibial component is placed in a lower angle of ER. Rotational alignment in UKA should be investigated in subsequent studies with larger sample sizes.
Level III, retrospective comparative study.
单髁膝关节置换术（UKA）在矢状面的理想位置在医学文献中尚未明确。本研究的目的是观察胫骨假体在矢状面的放置方式，并确定这是否会影响术后临床结果。
由一名外科医生对88例患者的101例UKA进行回顾性横断面研究。术后平均随访71个月（36至150个月）时进行CT扫描，并通过WOMAC和KSS评分评估临床和功能结果。根据不同的WOMAC或KSS值，患者多次被分为两组，每次比较分析矢状面角度差异。还分析了数据分布及其对结果的影响。
胫骨假体的平均外旋（ER）角度为11.9°（-1至32°）。在所有比较中，结果较好的组的ER角度较低。当将良好结果定义为WOMAC评分低于10分时，组间差异具有统计学意义。
由于采用徒手技术，矢状面定位的变异性（33°）高于其他平面。当胫骨假体以较低的ER角度放置时，观察到有更好结果的趋势。UKA的旋转对线应在后续更大样本量的研究中进行调查。
III级，回顾性比较研究。
