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UniCAP 为中年患者提供长期治疗,这些患者在最初 9 年内无需进行修订。

UniCAP offers a long term treatment for middle-aged patients, who are not revised within the first 9 years.

机构信息

Department of Emergency Medicine, Hospital of Southern Jutland, Kresten Philipsensvej 15, 6200, Aabenraa, Denmark.

Department of Orthopedic Surgery, Hospital of Southern Jutland, Soenderborg, Denmark.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1693-1697. doi: 10.1007/s00167-019-05356-y. Epub 2019 Feb 11.

Abstract

PURPOSE

The aim of this study was to investigate the long-term outcome of the unicompartmental knee resurfacing prosthesis (UniCAP) using clinical and radiographic assessments, and to evaluate the revision and survival rates.

METHODS

This was a prospective cohort study of patients with UniCAP prostheses with 6-9 years of follow-up. The clinical examination included the Knee Society Score (KSS) and Visual Analogue Scale (VAS) score. The radiographic examination included the Kellgren-Lawrence (KL) grading scale. A comparison analysis of the clinical preoperative and follow-up data and a Kaplan-Meier survival analysis were performed.

RESULTS

Of the 64 UniCAP patients, 36 (56%) were revised and one died. Examinations were performed on 23 (85%) of them. When compared with the preoperative data, the examinations showed a significant increase in the KSS objective [mean = 47.4, standard deviation (SD) = 5.8 vs. mean = 90.0, SD = 6.9] and function (mean = 46.7, SD = 6.8 vs. mean = 91.1, SD = 6.9) scores, a decrease in the VAS-score (mean = 7.3, SD = 0.5 vs. mean = 3.4, SD = 1.4) and a significant increase in the KL medial score (mean = 1.7, SD = 0.6 vs. mean = 2.1, SD = 0.5). The Kaplan-Meier survival rate after 5 years indicated good long-term outcomes.

CONCLUSIONS

There was a survival rate of approximately 40% after 9 years of follow-up, but in the group of patients (35-65 years old) not eligible for a final total arthroplasty. These patients were often left with pain and disability. This implant can be a temporary or even long-term treatment because it improved the disability and function over the long-term without a major progression in the osteoarthritis, function or pain. Long term results of this mini-prosthesis have not been previously reported.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在通过临床和影像学评估,调查单髁膝关节置换假体(UniCAP)的长期结果,并评估翻修率和生存率。

方法

这是一项对 UniCAP 假体患者进行的前瞻性队列研究,随访时间为 6-9 年。临床检查包括膝关节协会评分(KSS)和视觉模拟评分(VAS)。影像学检查包括 Kellgren-Lawrence(KL)分级。对临床术前和随访数据进行比较分析,并进行 Kaplan-Meier 生存分析。

结果

在 64 名 UniCAP 患者中,有 36 名(56%)进行了翻修,1 名死亡。对其中 23 名(85%)进行了检查。与术前数据相比,检查显示 KSS 客观评分[均值=47.4,标准差(SD)=5.8 比均值=90.0,SD=6.9]和功能评分[均值=46.7,SD=6.8 比均值=91.1,SD=6.9]显著增加,VAS 评分[均值=7.3,SD=0.5 比均值=3.4,SD=1.4]显著降低,KL 内侧评分[均值=1.7,SD=0.6 比均值=2.1,SD=0.5]显著增加。5 年后的 Kaplan-Meier 生存率表明长期预后良好。

结论

在 9 年的随访后,生存率约为 40%,但在不符合最终全膝关节置换条件的患者组(35-65 岁)中,这些患者常常伴有疼痛和残疾。这种植入物可以作为一种临时甚至长期的治疗方法,因为它在长期内改善了残疾和功能,而骨关节炎、功能或疼痛没有明显进展。这种小型假体的长期结果以前没有报道过。

证据等级

IV。

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