Panzram Benjamin, Bertlich Ines, Reiner Tobias, Walker Tilman, Hagmann Sébastien, Weber Marc-André, Gotterbarm Tobias
Clinic of Orthopedic and Trauma Surgery, University of Heidelberg, Heidelberg, Germany.
Clinic of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
PLoS One. 2017 Jan 19;12(1):e0170324. doi: 10.1371/journal.pone.0170324. eCollection 2017.
Tibial radiolucent lines (RL) are commonly seen in cemented unicompartmental knee replacement (UKR). In the postoperative course, they can be misinterpreted as signs of loosening, thus leading to unnecessary revision. Since 2004, a cementless OUKR is available. First studies and registry data have shown equally good clinical results of cementless OUKR compared to the cemented version and a significantly reduced incidence of RL in cementless implants.
This single-centre retrospective cohort study includes the first 30 UKR (27 patients) implanted between 2007 and 2009 with a mean follow-up of 5 years. Clinical outcome was evaluated using the OKS, AKS, range of movement (ROM) and level of pain (VAS). Standard radiologic evaluation was performed at three months, one and five years after surgery. The results five years after implantation were compared to a group of 27 cemented Oxford UKR (OUKR) in a matched-pair-analysis.
Tibial RL were seen in 10 implants three months after operation, which significantly decreased to five after one year and to three after five years (p = 0.02). RL did not have a significant influence on revision (p = 1.0) or clinical outcome after five years. RL were always partial, never progressive and strictly limited to the tibia. There was no significant difference in the incidence of tibial RL five years after implantation between cemented and cementless implants (cemented: 4, cementless: 3, p = 1.0).
After cementless implantation RL were limited to the tibia, partial and never progressive. During short term follow-up the incidence of RL decreased significantly. RL seem to have no influence on clinical outcome and revision.
胫骨透亮线（RL）在骨水泥型单髁膝关节置换术（UKR）中较为常见。在术后过程中，它们可能被误判为松动迹象，从而导致不必要的翻修。自2004年以来，有一种非骨水泥型OUKR可供使用。初步研究和登记数据表明，与骨水泥型相比，非骨水泥型OUKR的临床效果同样良好，且非骨水泥型植入物中RL的发生率显著降低。
这项单中心回顾性队列研究纳入了2007年至2009年间首次植入的30例UKR（27例患者），平均随访5年。使用OKS、AKS、活动范围（ROM）和疼痛程度（VAS）评估临床结果。在术后三个月、一年和五年进行标准的放射学评估。将植入五年后的结果与一组27例骨水泥型牛津单髁膝关节置换术（OUKR）进行配对分析。
术后三个月，10枚植入物出现胫骨RL，一年后显著降至5枚，五年后降至3枚（p = 0.02）。RL对五年后的翻修（p = 1.0）或临床结果没有显著影响。RL总是局部的，从不进展，且严格局限于胫骨。骨水泥型和非骨水泥型植入物植入五年后胫骨RL的发生率没有显著差异（骨水泥型：4例，非骨水泥型：3例，p = 1.0）。
非骨水泥植入后，RL局限于胫骨，为局部性且从不进展。在短期随访中，RL的发生率显著下降。RL似乎对临床结果和翻修没有影响。
