Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France.
Melbourne Orthopaedic Group, Windsor, Australia.
J Arthroplasty. 2019 Jun;34(6):1097-1104. doi: 10.1016/j.arth.2019.01.053. Epub 2019 Jan 29.
Survivorship of lateral unicompartmental knee arthroplasty (UKA) has progressively improved. However, there are few studies describing long-term results, and no study reports on polyethylene (PE) wear in lateral unicompartmental arthroplasty. The aims of this study are to determine the survival rate of lateral UKA with a fixed, all-PE bearing, and the PE wear of the tibial implant at a minimum of 15 years follow-up.
From January 1988 to October 2003, we performed 54 lateral UKAs in 52 patients. All patients had isolated lateral osteoarthritis (OA). The mean age at the index procedure was 65.4 ± 11 years. Thirty-nine UKAs were available for follow-up (30 alive and 9 dead after 15 years). Twelve patients had died before 15 years and 3 patients were lost to follow-up. The mean follow-up was 17.9 years (range, 15-23 years).
At the final follow-up, 8 knees of 39 (20.5%) had a surgical revision. The cumulative survival rate was 82.1% at 15 years and 79.4% at 20 years. The main reason of revision was progression of OA (87.5%), followed by aseptic loosening of the tibial component (12.5%). With a mean follow-up of 17.9 years, the mean PE wear was 0.061 mm/y. There was no radiographic loosening in the surviving implants and no revisions for wear. The mean functional International Knee Society score was 66.5 ± 26.8, with a mean objective score of 84.4 points ± 13.2. In the population without revision, 90.5% were satisfied or very satisfied at the latest follow-up.
Lateral UKA with a fixed, all-PE tibial bearing and a femoral resurfacing implant presents a high survivorship at long term, with very low PE wear.
外侧单髁膝关节置换术（UKA）的存活率逐渐提高。然而，很少有研究描述长期结果，也没有研究报告外侧单髁关节置换术中聚乙烯（PE）的磨损情况。本研究的目的是确定固定全 PE 承载体的外侧 UKA 的存活率，以及在至少 15 年随访时胫骨植入物的 PE 磨损情况。
1988 年 1 月至 2003 年 10 月，我们对 52 名患者的 54 例外侧 UKA 进行了手术。所有患者均为孤立性外侧骨关节炎（OA）。指数手术时的平均年龄为 65.4 ± 11 岁。39 例 UKA 可随访（30 例存活，15 年后 9 例死亡）。12 例患者在 15 年前死亡，3 例患者失访。平均随访时间为 17.9 年（范围为 15-23 年）。
末次随访时，39 例中有 8 例（20.5%）行手术翻修。15 年时累积生存率为 82.1%，20 年时为 79.4%。翻修的主要原因是 OA 进展（87.5%），其次是胫骨部件无菌性松动（12.5%）。在平均 17.9 年的随访中，平均 PE 磨损量为 0.061mm/y。存活植入物无影像学松动，无磨损翻修。平均国际膝关节协会功能评分 66.5 ± 26.8 分，客观评分 84.4 分±13.2 分。在未行翻修的人群中，90.5%的患者在末次随访时表示满意或非常满意。
采用固定全 PE 胫骨衬垫和股骨表面置换植入物的外侧 UKA 具有较高的长期存活率，PE 磨损非常低。
