Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th St, New York, New York, 10021, USA.
Department of Orthopaedic Surgery, Noordwest Hospital, Alkmaar, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2018 Jun;26(6):1811-1822. doi: 10.1007/s00167-017-4817-y. Epub 2017 Nov 28.
Due to the lack of comparative studies, a systematic review was conducted to determine revision rates of unicompartmental and total knee arthroplasty (UKA and TKA), and compare functional outcomes, range of motion and activity scores in patients less than 65 years of age.
A literature search was performed using PubMed, Embase, and Cochrane systems since 2000. 27 UKA and 33 TKA studies were identified and included. Annual revision rate (ARR), functional outcomes, and return to activity were assessed for both types of arthroplasty using independent t tests.
Four level I studies, 12 level II, 16 level III, and 29 level IV were included, which reported on outcomes in 2224 UKAs and 4737 TKAs. UKA studies reported 183 revisions, yielding an ARR of 1.00 and extrapolated 10-year survivorship of 90.0%. TKA studies reported 324 TKA revisions, resulting in an ARR of 0.53 and extrapolated 10-year survivorship of 94.7%. Functional outcomes scores following UKA and TKA were equivalent, however, following UKA larger ROM (125° versus 114°, p = 0.004) and higher UCLA scores were observed compared to TKA (6.9 versus 6.0, n.s.).
These results show that good-to-excellent outcomes can be achieved following UKA and TKA in patients less than 65 years of age. A higher ARR was noted following UKA compared to TKA. However, improved functional outcomes, ROM and return to activity were found after UKA than TKA in this young population. Comparative studies are needed to confirm these findings and assess factors contributing to failure at the younger patient population. Outcomes of UKA and TKA in patients younger than 65 years are both satisfying, and therefore, both procedures are not contraindicated at younger age. UKA has several important advantages over TKA in this young and frequently more active population.
IV.
由于缺乏比较研究，我们进行了一项系统评价，以确定单髁和全膝关节置换术（UKA 和 TKA）的翻修率，并比较小于 65 岁患者的功能结果、活动范围和活动评分。
从 2000 年起，我们在 PubMed、Embase 和 Cochrane 系统中进行了文献检索。确定并纳入了 27 项 UKA 和 33 项 TKA 研究。使用独立 t 检验评估两种关节置换术的年翻修率（ARR）、功能结果和恢复活动能力。
纳入了 4 项 I 级研究、12 项 II 级研究、16 项 III 级研究和 29 项 IV 级研究，共报告了 2224 例 UKA 和 4737 例 TKA 的结果。UKA 研究报告了 183 次翻修，ARR 为 1.00，外推 10 年生存率为 90.0%。TKA 研究报告了 324 例 TKA 翻修，ARR 为 0.53，外推 10 年生存率为 94.7%。UKA 和 TKA 后的功能结果评分相当，但 UKA 的活动范围更大（125°比 114°，p=0.004），UCLA 评分更高（6.9 比 6.0，无统计学意义）。
这些结果表明，小于 65 岁的患者行 UKA 和 TKA 可获得良好至优秀的结果。UKA 的 ARR 高于 TKA。然而，在这个年轻人群中，UKA 后功能结果、活动范围和恢复活动能力优于 TKA。需要进行比较研究来证实这些发现，并评估导致年轻患者群体失败的因素。小于 65 岁的患者行 UKA 和 TKA 的结果都令人满意，因此，在年轻患者中这两种手术都不是禁忌。在这个年轻且活动频繁的人群中，UKA 比 TKA 有几个重要优势。
IV。
Zotero 插件