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在一家地区综合医院对牛津单髁膝关节置换术进行长达11年随访的生存分析及功能转归

Survival analysis and functional outcome of the Oxford unicompartmental knee replacement up to 11 years follow up at a District General Hospital.

作者信息

Edmondson M, Atrey A, East D, Ellens N, Miles K, Goddard R, Apthorp H, Butler-Manuel A

机构信息

Conquest Hospital, East Sussex TN37 7RD, UK.

出版信息

J Orthop. 2015 May 18;12(Suppl 1):S105-10. doi: 10.1016/j.jor.2013.12.007. eCollection 2015 Oct.

DOI:10.1016/j.jor.2013.12.007
PMID:26719619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4674499/
Abstract

BACKGROUND

There have been several large originator studies reporting excellent results with this prosthesis but far fewer large independent studies. We present, to our knowledge, the largest independent series documenting excellent survivorship rates and good functional outcomes at a mean follow up of 5.5 years post implantation of the Oxford unicompartmental knee replacement.

METHODS

Our prospective study looks at the survivorship and the functional outcome of 364 Oxford UKRs performed in a district general hospital at a mean follow up of 5.5 years (range 5-11 years). Post operatively knees were assessed in a research clinic using the Oxford knees score (as well as the American Knee Society Score and the Hospital for Special Surgery Score). Maximal flexion was also measured.

RESULTS

There were 26 revisions of 364 knees giving a survivorship, with revision as the end point, of 93% at a mean of 5.5 years post op (range 5-11 years). We achieved an Oxford score of 37.5, a mean AKSS of 161 (divided as American knee functional score 75.75/American knee objective score 85.4 (excellent)). The mean HSS score was 84.5. We achieved 'Excellent' Oxford knee scores in 137 knees (48%), 'Good' in 75 (26%), 'Moderate' in 51 (17%) and 'Poor' in only 27 (9%) of knees. Mean improvement in functional scores were: Oxford score (14.4), AKSS (71) and HSS (26.3). Mean maximal flexion was 123° range (110-140).

CONCLUSIONS

We have confirmed that good medium to long-term function and survival can be obtained following Oxford medial knee replacement for treating anteromedial osteoarthritis, in our large independent series.

摘要

背景

已有多项由假体发明者开展的大型研究报告了使用该假体取得的优异结果,但独立开展的大型研究要少得多。据我们所知,我们呈现了规模最大的独立系列研究,记录了牛津单髁膝关节置换术后平均5.5年的出色生存率和良好功能结果。

方法

我们的前瞻性研究观察了一家区综合医院进行的364例牛津单髁膝关节置换术的生存率和功能结果,平均随访5.5年(范围5 - 11年)。术后在研究诊所使用牛津膝关节评分(以及美国膝关节协会评分和特种外科医院评分)对膝关节进行评估。还测量了最大屈曲度。

结果

364例膝关节中有26例进行了翻修,以翻修为终点,术后平均5.5年(范围5 - 11年)的生存率为93%。我们获得的牛津评分为37.5,美国膝关节协会评分平均为161(分为美国膝关节功能评分75.75/美国膝关节客观评分85.4(优秀))。美国特种外科医院(HSS)评分平均为84.5。我们的膝关节中,137例(48%)获得“优秀”的牛津膝关节评分,75例(26%)为“良好”,51例(17%)为“中等”,仅27例(9%)为“差”。功能评分的平均改善为:牛津评分(14.4)、美国膝关节协会评分(71)和美国特种外科医院评分(26.3)。平均最大屈曲度为123°(范围110 - 140)。

结论

在我们这个大型独立系列研究中,我们证实了牛津内侧膝关节置换术用于治疗前内侧骨关节炎可获得良好的中长期功能和生存率。

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本文引用的文献

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J Bone Joint Surg Br. 2011 Feb;93(2):198-204. doi: 10.1302/0301-620X.93B2.25767.
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The effect of leg alignment on the outcome of unicompartmental knee replacement.下肢力线对单髁膝关节置换术结果的影响。
J Bone Joint Surg Br. 2009 Apr;91(4):469-74. doi: 10.1302/0301-620X.91B4.22105.
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Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial.单髁或全膝关节置换术:一项前瞻性随机对照试验的15年结果
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Alignment in total knee replacement.全膝关节置换术中的对线
J Bone Joint Surg Br. 2008 Sep;90(9):1121-7. doi: 10.1302/0301-620X.90B9.20793.
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The short-term results of 3 common UKA implants during different periods in Sweden.瑞典不同时期3种常见英国膝关节单髁置换植入物的短期结果。
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Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomised clinical and radiological trial.采用微创股中肌入路或标准入路进行全膝关节置换:一项前瞻性随机临床和放射学试验。
J Bone Joint Surg Br. 2008 May;90(5):584-91. doi: 10.1302/0301-620X.90B5.20122.
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