Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Orthopedic Surgery, Medi-Yin Hospital, Paju, South Korea.
Int Orthop. 2018 Oct;42(10):2357-2363. doi: 10.1007/s00264-018-3880-4. Epub 2018 Mar 22.
The aim of the present study was to compare the clinical outcomes of mobile-bearing unicompartmental knee arthroplasty (MB-UKA) and open-wedge high tibial osteotomy (OWHTO) for advanced isolated medial osteoarthritis (OA).
Patients with advanced medial compartment OA (Ahlbäck grade ≥ II) who underwent either MB-UKA with Oxford Knee or OWHTO were included. The minimum follow-up was two years. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) score, knee score (KS), and function score (FS) of the Knee Society Knee Scoring System. Pre-operative and post-operative values were compared within groups. Pre-operative and post-operative values and the degree of change were compared between the two groups. Radiologic progression of OA in either the lateral or patellofemoral compartment was evaluated.
Forty knees (20 received MB-UKA, 20 received OWHTO) were enrolled. The mean age was higher in the MB-UKA group (67.9 ± 9.0 years) than in the OWHTO group (58.4 ± 5.5 years). The HSS score, KS, and FS were significantly increased post-operatively in both groups. The preoperative HSS score, KS, and FS were significantly lower in the MB-UKA than in the OWHTO group; however, only the post-operative HSS score was significantly higher in the MB-UKA group. The changes in HSS score and KS were also greater in the MB-UKA group. There was no significant difference in OA progression.
Although there was an age difference between the two groups, MB-UKA demonstrated superior short-term clinical outcomes to OWHTO for advanced isolated medial OA. In particular, MB-UKA was more effective in terms of pain relief.
本研究旨在比较单髁膝关节置换术（MB-UKA）和开放式楔形胫骨高位截骨术（OWHTO）治疗晚期内侧单间室骨关节炎（OA）的临床疗效。
纳入 Ahlbäck 分级≥Ⅱ级的晚期内侧间室 OA 患者，分别行牛津膝关节 MB-UKA 或 OWHTO。随访时间至少 2 年。采用美国特种外科医院（HSS）评分、膝关节评分（KS）和膝关节学会膝关节评分系统的功能评分（FS）评估临床疗效。组内比较术前和术后的评分，组间比较术前、术后的评分和变化程度。评估外侧间室或髌股间室 OA 的放射学进展。
共纳入 40 例膝关节（20 例行 MB-UKA，20 例行 OWHTO）。MB-UKA 组的平均年龄（67.9±9.0 岁）高于 OWHTO 组（58.4±5.5 岁）。两组术后 HSS 评分、KS 和 FS 均显著升高。MB-UKA 组术前 HSS 评分、KS 和 FS 均显著低于 OWHTO 组，而 MB-UKA 组术后 HSS 评分显著更高。MB-UKA 组 HSS 评分和 KS 的变化也更大。OA 进展无显著差异。
尽管两组间存在年龄差异，但 MB-UKA 治疗晚期内侧单间室 OA 的短期临床疗效优于 OWHTO。MB-UKA 在缓解疼痛方面更为有效。
