Stempin Radosław, Kaczmarek Wiesław, Stempin Kacper, Dutka Julian
Department of Orthopedic Surgery Promienista Clinic, Poznan, Poland.
Department of Orthopedic & Trauma Surgery Westallgäu Clinic, Wangen, Germany.
Open Orthop J. 2017 Oct 31;11:1173-1178. doi: 10.2174/1874325001711011173. eCollection 2017.
Cemented unicompartmental knee arthroplasty (UKA) yields good clinical outcome but common revision reasons are loosening and pain. Cementless UKA may reduce the revision rate.
The current study was designed to assess clinical and radiographic outcome of cemented and cementless UKA, using bone quality as determined by the Bone Hardness Test (BHT) as selection criterion for cementless implantation.
In this prospective comparative cohort study we analyzed 50 cementless and 29 Oxford consecutive UKA cases. Patients with sufficient bone quality were eligible for cementless UKA. Bone quality was assessed with the BHT, which consisted of exercising pressure with the thumb on the bone surface created after resection of the tibia.
The average surgical times were 62.5 ± 12.6 and 78 ± 16 minutes in the cementless and the cemented group, respectively (p < 0.01). The average thickness of the polyethylene insert was 4.3 ± 1.2 (range, 3 - 9) and 3.7 ± 0.8 (range, 3 - 6) mm, respectively (p = 0.02). Both types of implants yielded excellent clinical and functional results. At an average follow-up time of seven years, we found non-significant differences between clinical results of cementless versus cemented implants.
Shorter surgical time makes cementless implantation more attractive to surgeons when considering UKA options for their patients. The average thickness of the polyethylene insert in cementless group was 0.6 mm thinner than in the cemented group. The BHT is a simple and useful test to assess whether patients are eligible for cementless UKA.
骨水泥型单髁膝关节置换术（UKA）临床效果良好，但常见的翻修原因是假体松动和疼痛。非骨水泥型UKA可能会降低翻修率。
本研究旨在评估骨水泥型和非骨水泥型UKA的临床和影像学结果，将通过骨硬度测试（BHT）确定的骨质量作为非骨水泥植入的选择标准。
在这项前瞻性比较队列研究中，我们分析了50例非骨水泥型和29例牛津连续UKA病例。骨质量充足的患者符合非骨水泥型UKA的条件。使用BHT评估骨质量，该测试包括用拇指在胫骨切除后形成的骨表面施加压力。
非骨水泥组和骨水泥组的平均手术时间分别为62.5±12.6分钟和78±16分钟（p<0.01）。聚乙烯垫片的平均厚度分别为4.3±1.2（范围3 - 9）毫米和3.7±0.8（范围3 - 6）毫米（p = 0.02）。两种类型的植入物均产生了优异的临床和功能结果。平均随访7年时，我们发现非骨水泥型与骨水泥型植入物的临床结果之间无显著差异。
在为患者考虑UKA手术方案时，较短的手术时间使非骨水泥植入对外科医生更具吸引力。非骨水泥组聚乙烯垫片的平均厚度比骨水泥组薄0.6毫米。BHT是一种简单且有用的测试，可用于评估患者是否适合非骨水泥型UKA。
