Franz Alois, Boese Christoph Kolja, Matthies Andrej, Leffler Jörg, Ries Christian
Department of Orthopaedic Surgery and Sports Traumatology, St. Marien-Krankenhaus Siegen, Germany.
Department of Trauma and Orthopaedic Surgery, University Hospital of Cologne, Cologne, Germany.
J Knee Surg. 2019 May;32(5):468-474. doi: 10.1055/s-0038-1651528. Epub 2018 May 21.
Unicompartmental knee arthroplasty (UKA) has gained growing popularity over the last decades. The posterior tibial slope (PTS) has been shown to play a significant role for knee biomechanics and is thought to be crucial for clinical function of the UKA. We evaluated the clinical outcome at mid-term follow-up after UKA. Furthermore, the reconstruction of the individual PTS was analyzed. A total of 91 consecutive patients undergoing medial UKA for osteoarthritis were included. Patients were contacted by telephone for a survival analysis at a minimum of 30 months after surgery. Patient-oriented questionnaires and Knee Osteoarthritis Outcome Score (KOOS) were obtained. A retrospective chart review and radiological analysis of component alignment were performed for all patients before and at 6 weeks after surgery. Of 91 patients (93 knees) undergoing UKA, 69 patients (70 knees) were available for clinical follow-up after a mean of 56.0 (range 31-81) months post-surgery. The clinical results of the examined patients in the present study showed mean subscale scores of the KOOS and Western Ontario and McMaster Universities Osteoarthritis Index between 71 and 91%. Overall 7 of 91 patients were revised during the course of follow-up period and underwent total knee arthroplasty. A Kaplan-Meier analysis showed a survival rate for UKA of 90.5% after 48 months. Calculated implant survival was 75.9 months (95% confidence interval 72.3-79.6) at the mean. The radiographic analysis of pre- and postoperative PTS showed no differences ( = 0.113).UKA for osteoarthritis of the medial knee compartment shows encouraging clinical results at mid-term follow-up. The individual PTS could be reconstructed within acceptable ranges. This is a retrospective therapeutic study with Level IV.
在过去几十年中,单髁膝关节置换术(UKA)越来越受欢迎。后胫骨斜率(PTS)已被证明对膝关节生物力学起着重要作用,并且被认为对UKA的临床功能至关重要。我们评估了UKA中期随访的临床结果。此外,还分析了个体PTS的重建情况。总共纳入了91例因骨关节炎接受内侧UKA的连续患者。在术后至少30个月通过电话联系患者进行生存分析。获取了以患者为导向的问卷和膝关节骨关节炎结局评分(KOOS)。对所有患者在手术前和术后6周进行回顾性病历审查和假体对线的放射学分析。在91例接受UKA的患者(93个膝关节)中,69例患者(70个膝关节)在术后平均56.0(范围31 - 81)个月时可进行临床随访。本研究中被检查患者的临床结果显示,KOOS和西安大略和麦克马斯特大学骨关节炎指数的平均子量表评分在71%至91%之间。在随访期间,91例患者中有7例进行了翻修并接受了全膝关节置换术。Kaplan-Meier分析显示,48个月后UKA的生存率为90.5%。平均计算的假体生存率为75.9个月(95%置信区间72.3 - 79.6)。术前和术后PTS的放射学分析显示无差异(= 0.113)。内侧膝关节骨关节炎的UKA在中期随访中显示出令人鼓舞的临床结果。个体PTS可以在可接受的范围内重建。这是一项IV级回顾性治疗研究。