van Dorp Karin B, Breugem Stefan Jm, Bruijn Daniël J, Driessen Marcel Jm
Karin B van Dorp, Stefan JM Breugem, Daniël J Bruijn, Marcel JM Driessen, Orthopedium Clinics, 2616 LS Delft, Zuid-Holland, the Netherland.
World J Orthop. 2016 Apr 18;7(4):251-7. doi: 10.5312/wjo.v7.i4.251.
To investigate the short-term clinical results of the Oxford phase III cementless medial unicondylar knee prosthesis (UKP) compared to the cemented medial UKP.
We conducted a cross-sectional study in a tertairy orthopedic centre between the period of May 2010 and September 2012. We included 99 medial UKP in 97 patients and of these UKP, 53 were cemented and 46 were cementless. Clinical outcome was measured using a questionnaire, containing a visual analogue scale (VAS) for pain, Oxford Knee score, Kujala score and SF-12 score. Knee function was tested using the American Knee Society score. Complications, reoperations and revisions were recorded. Statistical significance was defined as a P value < 0.05.
In a mean follow-up time of 19.5 mo, three cemented medial UKP were revised to a total knee prosthesis. Reasons for revision were malrotation of the tibial component, aseptic loosening of the tibial component and progression of osteoarthritis in the lateral- and patellofemoral compartment. In five patients a successful reoperation was performed, because of impingement or (sub)luxation of the polyethylene bearing. Patients with a reoperation were significant younger than patients in the primary group (56.7 vs 64.0, P = 0.01) and were more likely to be male (85.7% vs 38.8%, P = 0.015). Overall the cementless medial UKP seems to perform better, but the differences in clinical outcome are not significant; a VAS pain score of 7.4 vs 11.7 (P = 0.22), an Oxford Knee score of 43.3 vs 41.7 (P = 0.27) and a Kujala score of 79.6 vs 78.0 (P = 0.63). The American Knee Society scores were slightly better in the cementless group with 94.5 vs 90.2 (P = 0.055) for the objective score and 91.2 vs 87.8 (P = 0.25) for the subjective score.
The cementless Oxford phase III medial UKP shows good short-term clinical results, when used in a specialist clinic by an experienced surgeon.
比较非骨水泥型牛津三期内侧单髁膝关节假体(UKP)与骨水泥型内侧UKP的短期临床效果。
2010年5月至2012年9月期间,我们在一家三级骨科中心进行了一项横断面研究。我们纳入了97例患者的99个内侧UKP,其中53个为骨水泥型,46个为非骨水泥型。使用包含视觉模拟评分(VAS)疼痛量表、牛津膝关节评分、库贾拉评分和SF - 12评分的问卷来测量临床结果。使用美国膝关节协会评分来测试膝关节功能。记录并发症、再次手术和翻修情况。统计学显著性定义为P值<0.05。
平均随访时间为19.5个月,3个骨水泥型内侧UKP翻修为全膝关节假体。翻修原因包括胫骨部件旋转不良、胫骨部件无菌性松动以及外侧和髌股关节间室骨关节炎进展。5例患者因聚乙烯衬垫撞击或(半)脱位进行了成功的再次手术。再次手术患者比初次手术组患者显著年轻(56.7对64.0,P = 0.01),且男性比例更高(85.7%对38.8%,P = 0.015)。总体而言,非骨水泥型内侧UKP似乎表现更好,但临床结果差异不显著;VAS疼痛评分为7.4对11.7(P = 0.22),牛津膝关节评分为43.3对41.7(P = 0.27),库贾拉评分为79.6对78.0(P = 0.63)。美国膝关节协会评分在非骨水泥组略好,客观评分为94.5对90.2(P = 0.055),主观评分为91.2对87.8(P = 0.25)。
非骨水泥型牛津三期内侧UKP由经验丰富的外科医生在专科诊所使用时,显示出良好的短期临床效果。