Kamenaga Tomoyuki, Hiranaka Takafumi, Hida Yuichi, Fujishiro Takaaki, Okamoto Koji
Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki General Hospital, 1-3-13, Kosobe-Chou, Takatsuki-City, Osaka, 569-1192, Japan.
Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki General Hospital, 1-3-13, Kosobe-Chou, Takatsuki-City, Osaka, 569-1192, Japan.
J Orthop Sci. 2018 Sep;23(5):807-810. doi: 10.1016/j.jos.2018.04.012. Epub 2018 Jun 19.
Malposition of the tibial components is a well-known complication of unicompartmental knee arthroplasty. In this study, we aimed to ascertain the relationship between the tibial component position and clinical outcomes of unicompartmental knee arthroplasty. We focused on the tibial component height and obliquity in the coronal plane.
Patients with anteromedial osteoarthritis who underwent Oxford mobile-bearing unicompartmental knee arthroplasty (n = 45) were included, and their Oxford knee score was assessed prior to and 1 and 2 years following surgery. We also assessed the postoperative tibial component position in the coronal plane using radiography, measuring the tibial component height and obliquity. We analyzed the sequential change in both clinical scores using repeated measures analysis of variance (p < 0.05). The effects of tibial component position on the clinical outcomes were analyzed using linear regression analysis (p < 0.05).
The Oxford knee score significantly improved 1 year after surgery. The tibial component height and obliquity had a significantly negative correlation with the 2-year postoperative Oxford knee score. They were also correlated significantly with Oxford knee score recovery after unicompartmental knee arthroplasty.
The 2-year postoperative outcomes of Oxford unicompartmental knee arthroplasty depended on the tibial component position. We observed poorer outcomes when the tibial component was placed at a lower level relative to the lateral compartment and when there was an excessive valgus angle relative to the lower limb axis.
胫骨部件位置不当是单髁膝关节置换术一种众所周知的并发症。在本研究中，我们旨在确定胫骨部件位置与单髁膝关节置换术临床疗效之间的关系。我们重点关注冠状面的胫骨部件高度和倾斜度。
纳入接受牛津活动平台单髁膝关节置换术的前内侧骨关节炎患者（n = 45），并在手术前以及术后1年和2年评估其牛津膝关节评分。我们还使用X线摄影评估术后冠状面的胫骨部件位置，测量胫骨部件高度和倾斜度。我们使用重复测量方差分析分析临床评分的序贯变化（p < 0.05）。使用线性回归分析分析胫骨部件位置对临床疗效的影响（p < 0.05）。
术后1年牛津膝关节评分显著改善。胫骨部件高度和倾斜度与术后2年牛津膝关节评分呈显著负相关。它们也与单髁膝关节置换术后牛津膝关节评分的恢复显著相关。
牛津单髁膝关节置换术的术后2年疗效取决于胫骨部件位置。当胫骨部件相对于外侧间室放置在较低水平以及相对于下肢轴线存在过度外翻角时，我们观察到较差的疗效。
