Kim Kyung Tae, Lee Song, Kim Jee Hyoung, Hong Sung Won, Jung Woo Shik, Shin Won Shik
Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.
Clin Orthop Surg. 2015 Jun;7(2):199-206. doi: 10.4055/cios.2015.7.2.199. Epub 2015 May 18.
In this study, we investigated the long-term clinical results and survival rate of minimally invasive unicompartmental knee arthroplasty (UKA) by collecting cases that had been implanted more than 10 years ago.
One hundred and twenty-eight patients (166 cases) who underwent Oxford phase 3 medial UKA using the minimally invasive surgery from January 2002 to December 2002 were selected. The mean age of the patients at the time of surgery was 61 years, and the duration of the follow-up was minimum 10 years. Clinical and radiographic assessments were performed using the Knee Society clinical rating system, and the survival analysis was done by the Kaplan-Meier method with 95% confidence interval (CI).
The mean Knee Society knee and function scores improved significantly from 53.8 points (range, 25 to 70 points) and 56.1 points (range, 35 to 80 points) preoperatively to 85.4 points (range, 58 to 100 points) and 80.5 points (range, 50 to 100 points) at 10-year follow-up, respectively (p < 0.001). Failures following the UKA occurred in 16 cases (9.6%), and the mean time of the occurrence of the failure was 6.2 years after the surgery. The 10-year survival rate was 90.5% (95% CI, 85.9 to 95.0) when failure was defined as all the reoperations, whereas the 10-year survival rate was 93.4% (95% CI, 89.6 to 97.1) when the cases in which only revision total knee arthroplasty was defined as failure.
The results of this study show outstanding functions of the knee joint and satisfactory 10-year survival rate after minimally invasive UKA. Therefore, minimally invasive UKA could be a useful method in the treatment of osteoarthritis in one compartment of knee joint.
在本研究中，我们通过收集10多年前植入的病例，调查了微创单髁膝关节置换术（UKA）的长期临床结果和生存率。
选取2002年1月至2002年12月期间采用微创手术进行牛津3期内侧UKA的128例患者（166膝）。手术时患者的平均年龄为61岁，随访时间至少为10年。使用膝关节协会临床评分系统进行临床和影像学评估，并采用Kaplan-Meier方法进行生存分析，置信区间为95%（CI）。
膝关节协会膝关节和功能评分的平均值从术前的53.8分（范围25至70分）和56.1分（范围35至80分）分别显著提高到10年随访时的85.4分（范围58至100分）和80.5分（范围50至100分）（p<0.001）。UKA术后失败16例（9.6%），失败发生的平均时间为术后6.2年。当将所有再次手术定义为失败时，10年生存率为90.5%（95%CI，85.9至95.0）；而当仅将翻修全膝关节置换术的病例定义为失败时，10年生存率为93.4%（95%CI，89.6至97.1）。
本研究结果显示，微创UKA术后膝关节功能优异，10年生存率令人满意。因此，微创UKA可能是治疗膝关节单髁骨关节炎的一种有用方法。
