Walker Tilman, Heinemann Pascal, Bruckner Thomas, Streit Marcus R, Kinkel Stefan, Gotterbarm Tobias
Clinic for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Arch Orthop Trauma Surg. 2017 Jul;137(7):895-902. doi: 10.1007/s00402-017-2702-2. Epub 2017 Apr 24.
The Oxford unicompartmental knee arthroplasty (OUKA) has been proven to be an effective treatment for anteromedial osteoarthritis of the knee joint. New instrumentation has been introduced to improve the reproducibility of implant positioning and to minimize bone loss during tibial resection (Oxford Microplasty; Zimmer Biomet, Warsaw, Indiana, USA).
To assess the effect of the new instrumentation, we retrospectively evaluated the postoperative radiographs and surgical records of 300 OUKAs in three consecutive cohorts of patients. The first cohort consists of the first 100 minimal invasive implantations of the OUKA using the conventional phase III instrumentation, the second cohort consists of the 100 most recent minimal invasive OUKA with the conventional phase III instrumentation and the third cohort consists of the first 100 minimal invasive OUKA using the new Oxford Microplasty instrumentation.
Mean bearing thickness was statistically significant and lower in OUKA with use of the updated instrumentation than with the conventional instrumentation (p = 0.01 and p = 0.04). Additionally, statistically significant and more femoral components were aligned within the accepted range of tolerance in both the coronal and the sagittal plane with use of the updated instrumentation compared to the conventional phase III instrumentation in group A (p = 0.029 and p = 0.038) and in the sagittal plane with use of the updated instrumentation compared to the conventional phase III instrumentation in group B (p = 0.002).
The new modified instrumentation seems to be an effective tool to reduce the risk of malalignment of the femoral component in the coronal and in the sagittal plane compared to the conventional phase III instrumentation. Furthermore, the instrumentation is also effective in determining an adequate level of tibial resection and thus avoiding unnecessary bone loss.
牛津单髁膝关节置换术（OUKA）已被证明是治疗膝关节前内侧骨关节炎的有效方法。已引入新的器械以提高植入物定位的可重复性，并在胫骨截骨过程中尽量减少骨质流失（牛津微创技术；美国印第安纳州华沙市的捷迈邦美公司）。
为评估新器械的效果，我们回顾性评估了连续三组患者中300例OUKA手术的术后X线片和手术记录。第一组包括使用传统III期器械进行的前100例OUKA微创植入手术，第二组包括使用传统III期器械进行的最近100例OUKA微创植入手术，第三组包括使用新的牛津微创技术进行的前100例OUKA微创植入手术。
使用更新后的器械进行OUKA手术时，平均垫片厚度在统计学上有显著差异，且低于使用传统器械时（p = 0.01和p = 0.04）。此外，与A组使用传统III期器械相比，使用更新后的器械时，在冠状面和矢状面内，更多的股骨组件在可接受的公差范围内对齐，差异有统计学意义（p = 0.029和p = 0.038）；与B组使用传统III期器械相比，在矢状面内，使用更新后的器械时差异有统计学意义（p = 0.002）。
与传统III期器械相比，新的改良器械似乎是一种有效的工具，可降低股骨组件在冠状面和矢状面内排列不齐的风险。此外，该器械在确定适当的胫骨截骨水平从而避免不必要的骨质流失方面也很有效。
