Xu Taotao, Lao Yangjun, Wang Jitao, Liu Fucun, Xiao Luwei, Tong Peijian
Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Institute of Orthopaedics and Traumatology of Zhejiang Province, Hangzhou, Zhejiang, China.
ANZ J Surg. 2017 Apr;87(4):287-290. doi: 10.1111/ans.13764. Epub 2016 Sep 27.
The purpose of this study was to evaluate the mid-term results of an Oxford phase-3 unicompartmental knee arthroplasty (UKA) for medial arthritis in Chinese patients.
The study included 64 patients who underwent a minimally invasive Oxford phase-3 UKA for medial knee arthritis. The patients were clinically evaluated preoperatively and at the final follow-up according to the clinical and functional components of the Knee Society Score (KSS), the Hospital for Special Surgery knee score and range of motion. A Kaplan-Meier survivorship analysis was performed with revision surgery as the end point.
The mean preoperative clinical KSSs increased from 63.2 to 91.4 post-operatively, and the mean functional KSSs increased from 54.9 to 86.5 post-operatively. In addition, the mean Hospital for Special Surgery scores increased from 59.5 to 86.4. The mean active knee flexion increased from 109.1° preoperatively to 123.6° post-operatively. A total of six patients (six knees) required revision surgery at the time of the maximum 10-year follow-up. Four conversions to total knee arthroplasty were performed because of arthritis progression in the lateral compartment. One revision to total knee arthroplasty was performed for aseptic loosening, and one liner exchange was performed for wear. The cumulative survival rates at the 6- and 8-year follow-ups were 97% and 93%, respectively.
Oxford phase-3 UKA was largely applicable for medial arthritis in Chinese patients. However, the Oxford phase-3 medial UKA selection criteria for young Chinese males need further exploration to obtain the best treatment effect.
本研究旨在评估牛津三期单髁膝关节置换术（UKA）治疗中国患者内侧关节炎的中期结果。
本研究纳入64例行微创牛津三期UKA治疗内侧膝关节关节炎的患者。根据膝关节协会评分（KSS）的临床和功能成分、特种外科医院膝关节评分及活动范围，对患者进行术前及末次随访时的临床评估。以翻修手术为终点进行Kaplan-Meier生存分析。
术前临床KSS平均得分从63.2提高到术后的91.4，功能KSS平均得分从54.9提高到术后的86.5。此外，特种外科医院平均得分从59.5提高到86.4。主动膝关节平均屈曲度从术前的109.1°增加到术后的123.6°。在最长10年的随访期内，共有6例患者（6膝）需要进行翻修手术。因外侧间室关节炎进展而进行了4例全膝关节置换术翻修。1例因无菌性松动进行全膝关节置换术翻修，1例因磨损进行衬垫更换。6年和8年随访时的累积生存率分别为97%和93%。
牛津三期UKA在很大程度上适用于中国患者的内侧关节炎。然而，对于中国年轻男性，牛津三期内侧UKA的选择标准需要进一步探索以获得最佳治疗效果。
