Panzram Benjamin, Bertlich Ines, Reiner Tobias, Walker Tilman, Hagmann Sébastien, Gotterbarm Tobias
Clinic of Orthopaedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany.
Arch Orthop Trauma Surg. 2017 Jul;137(7):1011-1017. doi: 10.1007/s00402-017-2696-9. Epub 2017 Apr 24.
Cemented unicompartmental knee replacement (UKR) has proven excellent long-term survival rates and functional scores in Price et al. (Clin Orthop Relat Res 435:171-180, 2005), Price and Svard (Clin Orthop Relat Res 469(1):174-179, 2011) and Murray et al. (Bone Joint Surg Br 80(6):983-989, 1998). The main causes for revision, aseptic loosening and pain of unknown origin might be addressed by cementless UKR in Liddle et al. (Bone Joint J 95-B(2):181-187, 2013), Pandit et al. (J Bone Joint Surg Am 95(15):1365-1372, 2013), National Joint Registry for England, Wales and Northern Ireland: 10th Annual Report 2013 ( http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/10th_annual_report/NJR%2010th%20Annual%20Report%202013%20B.pdf , 2013), Swedish Knee Arthroplasty Register: Annual Report 2013 ( http://www.myknee.se/pdf/SKAR2013_Eng.pdf , 2013).
This single-centre retrospective cohort study reports the 5-year follow-up results of our first 30 consecutively implanted cementless Oxford UKR (OUKR). Clinical outcome was measured using the OKS, AKSS, range of movement and level of pain (visual analogue scale). The results were compared to cemented OUKR in a matched-pair analysis.
Implant survival was 89.7%. One revision each was performed due to tibial fracture, progression of osteoarthritis (OA) and inlay dislocation. The 5-year survival rate of the cementless group was 89.7% and of the cemented group 94.1%. Both groups showed excellent postoperative clinical scores.
Cementless fixation shows good survival rates and clinical outcome compared to cemented fixation.
在普赖斯等人(《临床骨科及相关研究》435:171 - 180,2005年)、普赖斯和斯瓦德(《临床骨科及相关研究》469(1):174 - 179,2011年)以及默里等人(《骨与关节外科杂志(英国版)》80(6):983 - 989,1998年)的研究中,骨水泥型单髁膝关节置换术(UKR)已证实具有出色的长期生存率和功能评分。利德尔等人(《骨与关节杂志》95 - B(2):181 - 187,2013年)、潘迪特等人(《美国骨与关节外科杂志》95(15):1365 - 1372,2013年)、英格兰、威尔士和北爱尔兰国家关节注册中心:2013年第10次年度报告(http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/10th_annual_report/NJR%2010th%20Annual%20Report%202013%20B.pdf,2013年)、瑞典膝关节置换登记处:2013年年度报告(http://www.myknee.se/pdf/SKAR2013_Eng.pdf,2013年)指出,非骨水泥型UKR或许能解决翻修、无菌性松动及不明原因疼痛的主要问题。
本单中心回顾性队列研究报告了连续植入的首批30例非骨水泥型牛津UKR(OUKR)的5年随访结果。使用牛津膝关节评分(OKS)、美国膝关节协会评分(AKSS)、活动范围和疼痛程度(视觉模拟评分)来衡量临床结果。在配对分析中将结果与骨水泥型OUKR进行比较。
植入物生存率为89.7%。分别因胫骨骨折、骨关节炎(OA)进展和镶嵌物脱位各进行了1次翻修。非骨水泥组的5年生存率为89.7%,骨水泥组为94.1%。两组术后临床评分均优异。
与骨水泥固定相比,非骨水泥固定显示出良好的生存率和临床结果。