Department of Orthopedic Surgery, AZ Delta Hospital, Roeselare, Belgium.
J Arthroplasty. 2018 Sep;33(9):2792-2799. doi: 10.1016/j.arth.2018.04.031. Epub 2018 Apr 24.
Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant.
Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system. All patients were evaluated clinically and radiographically before surgery, and postoperatively at 6 weeks and 1 year. Between February and April 2016, all patients were reevaluated using the Oxford Knee Score.
Mean follow-up was 5.5 (range, 2-11) years. The mean Oxford Knee Score was 43.3 (7-48), with 94.6% patients showing excellent or good outcomes. Eleven revisions (2.4%) occurred. The survivorship was 97.2% (95% confidence interval, 96.2%-99.2%) and 94.2% (95% confidence interval, 86.8%-97.5%) at 5 and 10 years, respectively, with revision of any implant component for any reason as the end point. The causes for revision were infection (4 cases, 0.9%); lateral pain due to overload (2 cases, 0.4%); progression of OA in the lateral compartment (2 cases, 0.4%); patellar pain with patellar chondropathy (2 cases, 0.4%); and severe synovitis (1 cases, 0.2%). There were no reoperations or revisions for component loosening, instability, component wear, or periprosthetic fracture.
A fixed-bearing UKA system is a good treatment option for medial end-stage OA. Satisfactory functional results were achieved with low incidence of complications and revisions.
单髁膝关节置换术（UKA）是治疗孤立性内侧骨关节炎（OA）的全膝关节置换术的替代方法。然而，尽管临床效果令人满意，但 UKA 的翻修率仍然令人担忧。本回顾性研究报告了固定衬垫 UKA 植入物的长期存活率、功能结果和翻修原因。
2005 年至 2013 年，在一个中心使用固定衬垫 UKA 系统对 460 例连续患者进行了内侧 UKA 治疗。所有患者在术前、术后 6 周和 1 年均进行了临床和影像学评估。2016 年 2 月至 4 月，所有患者均采用牛津膝关节评分进行重新评估。
平均随访时间为 5.5（范围，2-11）年。平均牛津膝关节评分为 43.3（7-48）分，94.6%的患者表现出优秀或良好的结果。11 例（2.4%）进行了翻修。以任何原因翻修任何植入物组件为终点时，生存率分别为 97.2%（95%置信区间，96.2%-99.2%）和 94.2%（95%置信区间，86.8%-97.5%），分别在 5 年和 10 年时。翻修的原因是感染（4 例，0.9%）；因负荷过大导致外侧疼痛（2 例，0.4%）；外侧间室 OA 进展（2 例，0.4%）；髌股疼痛伴髌骨软骨病（2 例，0.4%）；严重滑膜炎（1 例，0.2%）。没有因组件松动、不稳定、组件磨损或假体周围骨折而进行再次手术或翻修。
固定衬垫 UKA 系统是治疗内侧终末期 OA 的一种较好的治疗选择。功能结果满意，并发症和翻修发生率低。
