Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1658-1664. doi: 10.1007/s00167-018-5299-2. Epub 2018 Nov 21.
Whether unicompartimental or total knee arthroplasty is superior for treatment of anteromedial knee osteoarthritis, is still uncertain. Therefore, the purpose of this study was to evaluate clinical and radiological outcome as well as long-term survivorship of medial Oxford unicompartmental knee arthroplasty (OUKA) at an independent center with a minimum follow-up of 10 years.
This single-center retrospective cohort study reports the 10-15 years follow-up results of 113 consecutive patients (126 knees) after medial OUKA. Survivorship analysis was performed with several different endpoints and clinical outcome was measured using the Oxford Knee Score (OKS), American Knee Society Score (AKSS-O), range of motion (ROM), Tegner activity score and UCLA score. Radiological analysis was performed with focus on progression of arthritis in the lateral compartment.
A total of 16 patients (16 knees) underwent revision surgery resulting in a survival rate of 92.4% at 10 years and 88.6% at 15 years with the endpoint device-related revisions. The main reason for revision surgery was progression of arthritis in five patients (31.3%) followed by persistency of pain in three patients (18.7%). Clinical outcome was good to excellent with an OKS of 39.9 at 11 years, an AKSS-O of 89.3 and a mean range of motion of 122°. The radiological analysis revealed a significant progression of degenerative changes in the lateral compartment, however without any impact on the functional outcome.
Oxford UKA of the medial compartment ensures good long-term survivorship with an excellent functional outcome. Therefore, the results of this study support the continued use of OUKA in patients with anteromedial osteoarthritis.
Retrospective cohort study, Level III.
单髁或全膝关节置换术治疗前内侧膝关节骨关节炎,哪种方法更优,目前仍不确定。因此,本研究旨在评估内侧牛津单髁膝关节置换术(OUKA)在一个独立中心的 10 年以上的临床和放射学结果以及长期生存率。
这是一项单中心回顾性队列研究,报告了内侧 OUKA 后 113 例(126 膝)连续患者的 10-15 年随访结果。采用多种不同的终点进行生存分析,使用牛津膝关节评分(OKS)、美国膝关节协会评分(AKSS-O)、关节活动度(ROM)、Tegner 活动评分和 UCLA 评分来衡量临床结果。放射学分析重点关注外侧间室关节炎的进展。
共有 16 例(16 膝)患者接受了翻修手术,10 年时的生存率为 92.4%,15 年时为 88.6%,以与器械相关的翻修为终点。翻修手术的主要原因是 5 例患者(31.3%)的关节炎进展,其次是 3 例患者(18.7%)的持续性疼痛。临床结果良好至优秀,OKS 为 11 年时的 39.9,AKSS-O 为 89.3,平均 ROM 为 122°。放射学分析显示外侧间室退行性改变明显进展,但对功能结果没有影响。
内侧 OUKA 确保了良好的长期生存率和出色的功能结果。因此,本研究结果支持在患有前内侧骨关节炎的患者中继续使用 OUKA。
回顾性队列研究,III 级。