Jonas Sam C, Jermin Paul, Howells Nick, Porteous Andrew, Murray James, Robinson James
Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.
Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.
Knee. 2019 Mar;26(2):400-404. doi: 10.1016/j.knee.2018.12.007. Epub 2019 Feb 18.
To compare outcomes of revision uni-compartmental knee replacement (UKR) with a defined revision cause with a matched group of primary total knee replacements (TKR).
UKR accounts for 8.7% of knee arthroplasty in the UK each year. It has better functional outcome than total knee replacement for isolated single compartment arthritis but can result in complex surgery when revision is required. This is feared to result in poorer patient reported outcomes when compared to primary TKR. We aim to compare the clinical results of revised UKR with primary TKR, taking into account the survival length of the UKR.
Forty-five patients (27 female) were retrospectively identified from our arthroplasty database that had undergone revision from UKR to TKR (1999-2014) and had a minimum of two years of follow-up post-revision. These patients were then matched with regards to age at primary procedure, sex, BMI and total arthroplasty life (UKR + Revision TKR) up to point of follow-up.
In the UKR revision group (mean arthroplasty life 8.6 years) the mean Oxford knee score (OKS) was 31.8. In the primary knee group (mean arthroplasty life 8.4 years) the mean OKS was 32.8. This difference was not statistically significant. Fifteen out of 45 patients undergoing revision surgery required stemmed components.
UKR provides comparable clinical outcome even after revision surgery to TKR as primary TKRs and should be considered in all patients meeting the selection criteria. Revision is complex and revision components should be available.
比较因特定翻修原因而行单髁膝关节置换翻修术(UKR)与匹配的初次全膝关节置换术(TKR)组的疗效。
在英国,UKR每年占膝关节置换术的8.7%。对于孤立的单髁关节炎,其功能结局优于全膝关节置换术,但翻修时可能导致复杂手术。与初次TKR相比,人们担心这会导致患者报告的结局较差。我们旨在比较翻修UKR与初次TKR的临床结果,同时考虑UKR的生存时长。
从我们的关节置换术数据库中回顾性识别出45例患者(27例女性),这些患者接受了从UKR到TKR的翻修术(1999 - 2014年),且翻修后至少有两年的随访。然后根据初次手术时的年龄、性别、体重指数和直至随访时的全关节置换寿命(UKR + 翻修TKR)对这些患者进行匹配。
在UKR翻修组(平均关节置换寿命8.6年)中,牛津膝关节评分(OKS)平均为31.8。在初次膝关节置换组(平均关节置换寿命8.4年)中,OKS平均为32.8。这种差异无统计学意义。45例接受翻修手术的患者中有15例需要带柄组件。
即使在翻修手术后,UKR与作为初次TKR的TKR相比,临床结局相当,所有符合选择标准的患者均应考虑采用。翻修手术复杂,应备有翻修组件。