Department of Orthopaedics, Campus Bio-Medico University of Rome, Rome, Italy.
Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, University of Leeds, United Kingdom.
J Arthroplasty. 2018 Jun;33(6):1727-1731. doi: 10.1016/j.arth.2018.01.035. Epub 2018 Feb 2.
The Oxford unicompartmental knee arthroplasty (OUKA) is a successful treatment for endstage, symptomatic anteromedial osteoarthritis. This study reports the results of a cohort of consecutive cemented and cementless medial OUKAs from an independent center and aims to answer the following questions: what is the survival of OUKA in the hands of a nondesigner surgeon? Are there any differences in the survival of cementless and cemented OUKA? Are the failure modes any different with the cementless and cemented OUKA?
One thousand one hundred twenty consecutive OUKAs were implanted in a single center for the recommended indications. Patients were prospectively identified and followed up. Survival was calculated with revision as the end point.
There were 522 cemented and 598 cementless implants. The mean follow-up was 8.3 years for cemented implants (range 0.5-17, standard deviation [SD] 2.9) and 2.7 years (range 0.5-7, SD 1.8) for cementless implants. The Oxford knee score improved from a preoperative mean of 22 (SD 8.1) to 40 (SD 7.9) at the last follow-up (P < .001). There were 59 failures requiring revision surgery, with a 5.3% cumulative revision rate. The most common reason for failure was progression of osteoarthritis in the lateral compartment, occurred in 26 cases (2.3%). The cumulative 10-year survival was 91% (95% confidence interval 87.3-95.2).
The results of this prospective, consecutive case series from the African continent demonstrated that excellent results are achievable with the OUKA in independent centers if the correct indications and surgical technique are used.
牛津单髁膝关节置换术（OUKA）是治疗晚期、有症状的前内侧骨关节炎的成功方法。本研究报告了来自一个独立中心的连续使用水泥固定和非水泥固定内侧 OUKA 的队列结果，并旨在回答以下问题：非设计医生手中的 OUKA 的生存率是多少？水泥固定和非水泥固定的 OUKA 生存率是否存在差异？水泥固定和非水泥固定的 OUKA 失败模式是否不同？
在一家单中心，按照推荐的适应证，连续植入了 1120 例 OUKA。前瞻性地识别并随访患者。以翻修为终点计算生存率。
共有 522 例水泥固定和 598 例非水泥固定植入物。水泥固定植入物的平均随访时间为 8.3 年（范围 0.5-17，标准差[SD]2.9），非水泥固定植入物为 2.7 年（范围 0.5-7，SD 1.8）。牛津膝关节评分从术前的平均 22（SD8.1）改善至末次随访时的 40（SD7.9）（P<0.001）。需要翻修手术的失败有 59 例，累积翻修率为 5.3%。最常见的失败原因是外侧间室骨关节炎的进展，发生在 26 例（2.3%）中。累积 10 年生存率为 91%（95%置信区间 87.3-95.2）。
这项来自非洲大陆的前瞻性、连续病例系列研究结果表明，如果使用正确的适应证和手术技术，OUKA 在独立中心也可以取得出色的结果。
