Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands.
Department of Orthopaedic Surgery and Computer Assisted Surgery Center, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA.
Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2276-2288. doi: 10.1007/s00167-019-05357-x. Epub 2019 Jan 28.
To determine survivorship and functional outcomes of fixed and mobile-bearing designs in lateral unicompartmental knee arthroplasties (UKA).
Medline, EMBASE and Cochrane databases were searched. Annual revision rate and functional outcomes were assessed for both fixed and mobile-bearing designs.
A total of 28 studies, of which 19 fixed-bearing and 9 mobile-bearing, representing 2265 lateral UKAs were included for survivorship and functional outcome analyses. The mean follow-up of fixed and mobile-bearing studies was 7.5 and 3.9 years, respectively. Annual revision rate of fixed-bearing designs was 0.94 (95% CI 0.66-1.33) compared to 2.16 (95% CI 1.54-3.04) for mobile-bearing. A subgroup analysis of the domed shaped mobile-bearing design noted an annual revision rate of 1.81 (95% CI 0.98-3.34). Good-to-excellent functional outcomes were observed following fixed and mobile-bearing lateral UKAs; no significant differences were found.
Mobile-bearing lateral UKAs have a higher rate of revision compared to fixed-bearing lateral UKAs with regard to short- to mid-term survivorship; however, the clinical outcomes are similar. Despite the introduction of the domed shaped mobile-bearing design, findings of this study suggest fixed-bearing implant design is preferable in the setting of isolated lateral osteoarthritis (OA). This systematic review was based on low to moderate evidence, therefore, future registry data are needed to confirm these findings. However, this study included a large number of patients, and could provide information regarding risk of revision and functional outcomes of mobile and fixed-bearing type lateral UKA.
IV.
确定固定和活动衬垫设计在外侧单髁膝关节置换术中的生存率和功能结果。
检索 Medline、EMBASE 和 Cochrane 数据库。评估了两种固定和活动衬垫设计的年返修率和功能结果。
共纳入 28 项研究，其中 19 项为固定衬垫设计，9 项为活动衬垫设计，共涉及 2265 例外侧单髁膝关节置换术，用于生存率和功能结果分析。固定和活动衬垫研究的平均随访时间分别为 7.5 年和 3.9 年。固定衬垫设计的年返修率为 0.94（95%CI 0.66-1.33），而活动衬垫设计为 2.16（95%CI 1.54-3.04）。对穹顶形活动衬垫设计的亚组分析显示，年返修率为 1.81（95%CI 0.98-3.34）。固定和活动衬垫外侧单髁膝关节置换术后均获得良好至优秀的功能结果；但差异无统计学意义。
在短期至中期生存率方面，活动衬垫外侧单髁膝关节置换术的返修率高于固定衬垫外侧单髁膝关节置换术；但临床结果相似。尽管引入了穹顶形活动衬垫设计，但本研究的结果表明，在单纯外侧骨关节炎（OA）的情况下，固定衬垫植入物设计更为可取。本系统评价基于低到中等质量的证据，因此需要未来的登记数据来证实这些发现。然而，本研究纳入了大量患者，可为移动和固定衬垫式外侧单髁膝关节置换术的返修风险和功能结果提供信息。
IV。
