Greco Nicholas J, Cook Gary J E, Lombardi Adolph V, Adams Joanne B, Berend Keith R
Joint Implant Surgeons, Inc., New Albany, Ohio, Department of Orthopaedics The Ohio State University Wexner Medical Center, Columbus, Ohio.
Joint Implant Surgeons, Inc., New Albany, Ohio, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania.
Surg Technol Int. 2019 May 15;34:371-378.
Treatment of isolated lateral compartment arthritic disease with partial knee arthroplasty remains underutilized in comparison to medial unicompartmental arthroplasty. This study examines the survival and outcome of lateral unicompartmental arthroplasty utilizing the first implant specifically developed for the lateral compartment.
A retrospective review was performed to detect lateral unicompartmental arthroplasty procedures performed in our practice between January 2013 and May 2016. Patients indicated for surgery met specific preoperative clinical and radiographic criteria confirming lateral compartment arthritic disease with a correctable deformity, intact full-thickness medial cartilage, competent anterior cruciate ligament, and minimal disease in the patellofemoral compartment. A single implant design was used in all cases which consisted of a fixed-bearing tibial component specifically adapted to lateral compartment anatomy. Unicompartmental arthroplasty surgical technique was adjusted to attempt to recreate lateral compartment kinematics.
Fifty-two consecutive patients (56 knees) with lateral unicompartmental arthroplasty procedures meeting minimum two-year follow up were included in the study. Thirty-nine patients were female, and 93% of cases were performed for treatment of osteoarthritis. At a mean follow up of nearly three years, Knee Society clinical and functional scores improved postoperatively by a mean difference of 41 and 21, respectively. There were two reoperations, one medial unicompartmental arthroplasty for osteoarthritis progression and a superficial debridement for a non-healing wound. Thus, failure of lateral unicondylar knee arthroplasty (UKA) was less than 2% in this study. There were no other component revisions, radiographic evidence of loosening, or clinical failures.
At early follow up, lateral unicompartmental arthroplasty using a modified surgical technique and an implant specifically designed for the lateral compartment is a reliable treatment for isolated lateral femorotibial arthritis when meeting defined indications.
与内侧单髁关节置换术相比，采用部分膝关节置换术治疗孤立性外侧间室关节炎疾病的应用仍然不足。本研究探讨了使用专门为外侧间室开发的首款植入物进行外侧单髁关节置换术的生存率和疗效。
进行一项回顾性研究，以检测2013年1月至2016年5月期间在我们科室进行的外侧单髁关节置换术。拟行手术的患者符合特定的术前临床和影像学标准，确认外侧间室关节炎疾病伴有可纠正的畸形、完整的全层内侧软骨、功能正常的前交叉韧带以及髌股间室疾病轻微。所有病例均使用单一植入物设计，该设计包括一个专门适配外侧间室解剖结构的固定平台胫骨部件。调整单髁关节置换手术技术以试图重建外侧间室的运动学。
本研究纳入了52例连续接受外侧单髁关节置换术且至少随访两年的患者（56膝）。39例为女性，93%的病例是为治疗骨关节炎而进行的。平均随访近三年时，膝关节协会临床和功能评分术后分别平均提高了41分和21分。有两次再次手术，一次是因骨关节炎进展而行内侧单髁关节置换术，另一次是因伤口不愈合而行浅表清创术。因此，本研究中外侧单髁膝关节置换术（UKA）的失败率低于2%。没有其他部件翻修、松动的影像学证据或临床失败情况。
在早期随访中，当符合明确指征时，采用改良手术技术和专门为外侧间室设计的植入物进行外侧单髁关节置换术是治疗孤立性外侧股胫关节炎的可靠方法。
