Kendrick B J L, Kaptein B L, Valstar E R, Gill H S, Jackson W F M, Dodd C A F, Price A J, Murray D W
NDORMS, University of Oxford, Windmill Road, OX3 7LD, UK.
Biomechanics and Imaging Group, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Bone Joint J. 2015 Feb;97-B(2):185-91. doi: 10.1302/0301-620X.97B2.34331.
The most common reasons for revision of unicompartmental knee arthroplasty (UKA) are loosening and pain. Cementless components may reduce the revision rate. The aim of this study was to compare the fixation and clinical outcome of cementless and cemented Oxford UKAs. A total of 43 patients were randomised to receive either a cemented or a cementless Oxford UKA and were followed for two years with radiostereometric analysis (RSA), radiographs aligned with the bone-implant interfaces and clinical scores. The femoral components migrated significantly during the first year (mean 0.2 mm) but not during the second. There was no significant difference in the extent of migration between cemented and cementless femoral components in either the first or the second year. In the first year the cementless tibial components subsided significantly more than the cemented components (mean 0.28 mm (sd 0.17) vs. 0.09 mm (sd 0.19 mm)). In the second year, although there was a small amount of subsidence (mean 0.05 mm) there was no significant difference (p = 0.92) between cemented and cementless tibial components. There were no femoral radiolucencies. Tibial radiolucencies were narrow (< 1 mm) and were significantly (p = 0.02) less common with cementless (6 of 21) than cemented (13 of 21) components at two years. There were no complete radiolucencies with cementless components, whereas five of 21 (24%) cemented components had complete radiolucencies. The clinical scores at two years were not significantly different (p = 0.20). As second-year migration is predictive of subsequent loosening, and as radiolucency is suggestive of reduced implant-bone contact, these data suggest that fixation of the cementless components is at least as good as, if not better than, that of cemented devices.
单髁膝关节置换术（UKA）翻修的最常见原因是松动和疼痛。非骨水泥型假体可能会降低翻修率。本研究的目的是比较非骨水泥型和骨水泥型牛津单髁膝关节置换术的固定情况及临床疗效。总共43例患者被随机分为接受骨水泥型或非骨水泥型牛津单髁膝关节置换术，并通过放射立体测量分析（RSA）、与骨-植入物界面对齐的X线片以及临床评分进行了两年的随访。股骨假体在第一年显著移位（平均0.2毫米），但在第二年没有。在第一年或第二年，骨水泥型和非骨水泥型股骨假体的移位程度没有显著差异。在第一年，非骨水泥型胫骨假体的下沉明显多于骨水泥型假体（平均0.28毫米（标准差0.17）对0.09毫米（标准差0.19毫米））。在第二年，尽管有少量下沉（平均0.05毫米），但骨水泥型和非骨水泥型胫骨假体之间没有显著差异（p = 0.92）。股骨没有出现透亮线。胫骨透亮线较窄（<1毫米），在两年时，非骨水泥型（21例中的6例）比骨水泥型（21例中的13例）显著更少见（p = 0.02）。非骨水泥型假体没有出现完全透亮线，而21例骨水泥型假体中有5例（24%）出现了完全透亮线。两年时的临床评分没有显著差异（p = 0.20）。由于第二年的移位可预测随后的松动，且透亮线提示植入物与骨的接触减少，这些数据表明非骨水泥型假体的固定至少与骨水泥型假体一样好，甚至可能更好。
