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单髁膝关节置换术后胫骨后倾的中期临床疗效及重建

Mid-Term Clinical Outcome and Reconstruction of Posterior Tibial Slope after UKA.

作者信息

Franz Alois, Boese Christoph Kolja, Matthies Andrej, Leffler Jörg, Ries Christian

机构信息

Department of Orthopaedic Surgery and Sports Traumatology, St. Marien-Krankenhaus Siegen, Germany.

Department of Trauma and Orthopaedic Surgery, University Hospital of Cologne, Cologne, Germany.

出版信息

J Knee Surg. 2019 May;32(5):468-474. doi: 10.1055/s-0038-1651528. Epub 2018 May 21.

Abstract

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.

摘要

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。

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