Kim Sang-Gyun, Kim Hyun-Gon, Lee Seung-Yup, Lim Hong-Chul, Bae Ji-Hoon
Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Orthopaedic Surgery, Seoul Barunsesang Hospital, Seoul, Korea.
Knee Surg Relat Res. 2018 Sep 1;30(3):234-240. doi: 10.5792/ksrr.17.085.
This study was conducted to investigate the outcomes of bearing exchange for the treatment of mobile bearing dislocation in medial unicompartmental knee arthroplasty (UKA).
We retrospectively reviewed 18 patients (15 females and 3 males, mean age of 65 years) treated with bearing exchange following mobile bearing dislocation in medial UKA. The occurrence of bearing redislocation, the Oxford Knee Score, and radiographic changes at the last follow-up were investigated.
Bearing redislocation after bearing exchange occurred in 9 of 18 patients (50%). Of these 9 patients, 7 underwent conversion to total knee arthroplasty after bearing redislocation. The 9 patients without bearing redislocation showed good to excellent clinical outcomes at a mean follow-up of 55 months after bearing exchange. The non-redislocation group had a higher percentage of posterior dislocation of the bearing than the redislocation group (55.5% vs. 22.2%, p=0.040). Univariate logistic regression analysis showed no significant risk factors for bearing redislocation.
This study showed a high rate of bearing redislocation after isolated, mobile bearing exchange for bearing dislocation following medial UKA. Therefore, bearing exchange as a sole treatment should be carefully considered in selected patients with correctable causes of bearing dislocation.
本研究旨在探讨在膝关节单髁置换术(UKA)中进行垫片置换治疗活动垫片脱位的效果。
我们回顾性分析了18例在内侧UKA活动垫片脱位后接受垫片置换治疗的患者(15例女性,3例男性,平均年龄65岁)。研究了垫片再次脱位的发生情况、牛津膝关节评分以及末次随访时的影像学变化。
18例患者中有9例(50%)在垫片置换后发生垫片再次脱位。在这9例患者中,7例在垫片再次脱位后接受了全膝关节置换术。9例未发生垫片再次脱位的患者在垫片置换后平均55个月的随访中显示出良好至优秀的临床效果。未脱位组垫片后脱位的比例高于脱位组(55.5%对22.2%,p = 0.040)。单因素逻辑回归分析显示,没有显著的垫片再次脱位危险因素。
本研究表明,在内侧UKA后孤立的活动垫片脱位进行垫片置换后,垫片再次脱位的发生率较高。因此,对于有可纠正垫片脱位原因的特定患者,应谨慎考虑将垫片置换作为唯一的治疗方法。