Jang Ki-Mo, Lim Hong Chul, Han Seung-Beom, Jeong Chandong, Kim Seul-Gi, Bae Ji-Hoon
Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Department of Orthopaedic Surgery, Seoul Barunsesang Hospital, Seoul, South Korea.
Knee. 2017 Jun;24(3):641-650. doi: 10.1016/j.knee.2017.02.001. Epub 2017 Mar 19.
A new instrument system has been introduced to improve the accuracy and reproducibility of implant positioning in Oxford® unicompartmental knee arthroplasty (UKA). This study aimed to determine if the new instrumentation could improve postoperative implant positioning and limb alignment, and reduce the occurrence of outliers in Oxford® UKA.
A total of 77 cases of Oxford® UKA with the new instrumentation were included. Individual matching for the conventional instrument group was performed according to age, sex, and body mass index. Postoperative radiological variables, including the hip-knee-ankle angle and the varus/valgus and flexion/extension angles of the femoral and tibial implants, were measured and compared between the new instrumentation group and the conventional group. The outliers in implant positions and postoperative complications were also compared.
No significant between-group differences were observed in terms of lower limb alignment and tibial implant alignment. However, statistically significant differences were identified in the varus/valgus and flexion/extension angles of the femoral implant (P=0.01 and P<0.001, respectively). More outliers were observed in the flexion/extension angles of the femoral and tibial implants in the new instrumentation group. Eight meniscal bearing dislocations and three lateral compartmental degenerative changes were found in the conventional group, while there were two meniscal bearing dislocations in the new instrumentation group during the study period.
The present study did not confirm any benefit of the new instrument system in terms of postoperative limb alignment, positioning of the implant, or reducing outliers beyond the use of the conventional instruments.
已引入一种新的器械系统，以提高牛津单髁膝关节置换术（UKA）中植入物定位的准确性和可重复性。本研究旨在确定新器械是否能改善术后植入物定位和肢体对线，并减少牛津UKA中异常值的发生。
共纳入77例使用新器械的牛津UKA病例。根据年龄、性别和体重指数对传统器械组进行个体匹配。测量并比较新器械组和传统组术后的放射学变量，包括髋-膝-踝角以及股骨和胫骨植入物的内翻/外翻和屈伸角度。还比较了植入物位置的异常值和术后并发症。
在下肢对线和胫骨植入物对线方面，未观察到组间有显著差异。然而，在股骨植入物的内翻/外翻和屈伸角度方面发现了统计学上的显著差异（分别为P = 0.01和P < 0.001）。新器械组在股骨和胫骨植入物的屈伸角度方面观察到更多异常值。在研究期间，传统组发现8例半月板承重脱位和3例外侧间室退变改变，而新器械组有2例半月板承重脱位。
本研究未证实新器械系统在术后肢体对线、植入物定位或减少传统器械使用之外的异常值方面有任何益处。
