Lo Presti Mirco, Raspugli Giovanni Francesco, Reale Davide, Iacono Francesco, Zaffagnini Stefano, Filardo Giuseppe, Marcacci Maurilio
2nd Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
Department of Biomedical Sciences, Humanitas University, Humanitas Clinical and Research Center, Milan, Italy.
J Knee Surg. 2019 Sep;32(9):860-865. doi: 10.1055/s-0038-1669448. Epub 2018 Sep 13.
Survivorship of unicondylar knee arthroplasty (UKA) remains a drawback, especially compared with the outcome of total knee arthroplasty. This could be improved by identifying and correcting failure mechanisms. To this purpose, this study aimed at exploring failure modalities of UKA, with particular focus on the role of joint line (JL) position and alignment as variable to be optimized for a successful outcome. This study explored modes of failure in 266 medial UKAs. Radiological comparison was performed between 24 failures and 24 matched controls, to determine the importance of UKA positioning in terms of femorotibial angle (FTA), tibial plateau angle, and posterior tibial slope (PTS). Radiographic comparative analysis showed statistically significant differences in the failure group compared with the control group in terms of variation in FTA ( = 0.0222), PTS ( = 0.0025), and JL height ( = 0.0022). Variations not only in FTA but also PTS and JL height were correlated with failures observed in this series. Thus, based on the results of this study, it emerges that JL position should be carefully controlled in all planes while implanting a UKA. This is a Level III, case-control study.
单髁膝关节置换术（UKA）的生存率仍然是一个缺点，尤其是与全膝关节置换术的结果相比。通过识别和纠正失败机制可以改善这一情况。为此，本研究旨在探索UKA的失败模式，特别关注关节线（JL）位置和对线作为可优化以获得成功结果的变量的作用。本研究探索了266例内侧UKA的失败模式。对24例失败病例和24例匹配对照进行了影像学比较，以确定UKA在股骨胫骨角（FTA）、胫骨平台角和胫骨后倾（PTS）方面定位的重要性。影像学比较分析显示，失败组与对照组相比，在FTA变化（=0.0222）、PTS（=0.0025）和JL高度（=0.0022）方面存在统计学显著差异。本系列观察到的失败不仅与FTA的变化有关，还与PTS和JL高度的变化有关。因此，基于本研究结果，在植入UKA时，应在所有平面上仔细控制JL位置。这是一项III级病例对照研究。
