Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University, Seoul, South Korea.
Department of Orthopedic Surgery, Hanmaeum Changwon Hospital, Han-Yang University, Changwon-Si, Kyungsangnam-Do, South Korea.
Int Orthop. 2019 Feb;43(2):315-322. doi: 10.1007/s00264-018-4028-2. Epub 2018 Jun 19.
Revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) is technically demanding but can be performed with computer navigation system guidance. The purpose of this study was (1) to compare the outcomes of revision of UKA to TKA to those of primary TKA and (2) to describe a surgical technique for the revision of UKA to TKA using a navigation system.
From May 2011 to April 2014, a total of 298 knees underwent primary navigation-assisted TKA (group 1), and navigation-assisted UKA revision to TKA was performed in 15 patients (group 2). One to three propensity score matching was performed to compare the two groups after a minimum of three years of follow-up. Radiographic and clinical outcomes in addition to radiolucent lines were evaluated during follow-up.
In group 1, there was one case that required metal block augmentation with the long stem under the tibial plate due to severe bone loss, while in other cases, short stems were used, and cement and autogenous bone grafts were used to fill bone defects due to minimal bone loss. Pre- and post-operative outcomes were significantly improved in both groups (p < 0.001). There were no statistical differences between groups in pre- and post-operative outcomes except post-operative Knee Society Function Score (KSFS) (p = 0.008). There were no radiolucent lines in the tibia or femur in either group during follow-up.
With the use of an appropriate surgical technique, navigation-assisted revision of UKA to TKA can yield clinical and radiologic outcomes comparable to those of primary navigation-assisted TKA.
Level IV.
单髁膝关节置换术（UKA）翻修为全膝关节置换术（TKA）技术要求较高，但可在计算机导航系统引导下完成。本研究的目的是：（1）比较 UKA 翻修为 TKA 的结果与初次 TKA 的结果；（2）描述一种使用导航系统进行 UKA 翻修为 TKA 的手术技术。
2011 年 5 月至 2014 年 4 月，共有 298 例膝关节接受了初次导航辅助 TKA（组 1），15 例患者接受了导航辅助 UKA 翻修为 TKA（组 2）。在至少 3 年的随访后，通过 1 到 3 次倾向评分匹配比较两组。在随访期间评估了影像学和临床结果以及透光线。
在组 1 中，由于严重的骨丢失，有 1 例胫骨板下需要使用长柄金属块进行增强，而在其他病例中，由于骨丢失较小，使用了短柄，并用骨水泥和自体骨移植填充骨缺损。两组的术前和术后结果均显著改善（p<0.001）。除术后膝关节学会功能评分（KSFS）外（p=0.008），两组的术前和术后结果无统计学差异。在随访期间，两组在胫骨或股骨均无透光线。
使用适当的手术技术，导航辅助 UKA 翻修为 TKA 可获得与初次导航辅助 TKA 相当的临床和影像学结果。
IV 级。
