Xue Huaming, Tu Yihui, Ma Tong, Wen Tao, Yang Tao, Cai Minwei
Department of Orthopaedic Surgery, Yangpu District Central Hospital, Tongji University School of Medicine, 450 TengYue Road, Shanghai, 200090, China.
Int Orthop. 2017 Aug;41(8):1571-1577. doi: 10.1007/s00264-017-3492-4. Epub 2017 May 10.
There have been few large sample studies reporting the midterm outcome of Oxford phase 3 unicompartmental knee arthroplasty (UKA) in Asian patients.
The study included 708 consecutive medial Oxford UKAs between February 2005 and May 2014 in Chinese patients. All cases were performed for the recommended indications with a minimally-invasive surgical technique. The functional and radiological outcomes were subsequently examined. In particular, we divided patients into the spontaneous osteonecrosis of the knee (SONK) group and the osteoarthritis (OA) group.
All patients were reviewed with a mean follow-up of 6.2 years (range 2.7-12 years). At the latest follow up, the mean Oxford knee score (OKS) increased from 22.5 to 38.5 points, while the mean knee society score (KSS) increased from 43.6 to 86.1 points. The mean visual analogue scale pain score decreased from 7.9 to 1.5 points and the mean range of motion (ROM) increased from 112.5° to 125.2°. A total of 13 UKAs (1.88%) required revisions. The most common reason was bearing dislocation and osteoarthritis of the lateral compartment. Using revision for any cause as an endpoint, the five-year cumulative survival rate was 98.8% and the ten-year survival rate was 94.3%. There was no statistically significant difference between the SONK group and the OA group for the five-year cumulative survival rate (98.7% vs. 98.8%, P > 0.05).
This study demonstrates that Oxford UKA is a good option for the treatment of anteromedial OA and SONK of the knee in Asian patients.
鲜有大型样本研究报道亚洲患者接受牛津三期单髁膝关节置换术（UKA）的中期结果。
本研究纳入了2005年2月至2014年5月期间连续进行的708例中国患者的内侧牛津UKA手术。所有病例均按照推荐适应症采用微创外科技术进行。随后检查功能和影像学结果。特别地，我们将患者分为膝关节自发性骨坏死（SONK）组和骨关节炎（OA）组。
所有患者均接受了随访，平均随访时间为6.2年（范围2.7 - 12年）。在最近一次随访时，牛津膝关节平均评分（OKS）从22.5分提高到38.5分，而膝关节协会平均评分（KSS）从43.6分提高到86.1分。视觉模拟量表疼痛平均评分从7.9分降至1.5分，平均活动范围（ROM）从112.5°增加到125.2°。共有13例UKA（1.88%）需要翻修。最常见的原因是假体脱位和外侧间室骨关节炎。以任何原因进行翻修为终点，五年累积生存率为98.8%，十年生存率为94.3%。SONK组和OA组的五年累积生存率无统计学显著差异（98.7%对98.8%，P>0.05）。
本研究表明，牛津UKA是治疗亚洲患者膝关节前内侧OA和SONK的良好选择。
