Stempin Radosław, Stempin Kacper, Kaczmarek Wiesław
Department of Orthopedic & Trauma Surgery, J. Strus Memorial (Multispecialistic City) Hospital, Poznan, Poland.
Department of Orthopedic & Trauma Surgery, Westallgäu Clinic, Wangen, Germany.
Ann Transl Med. 2019 Feb;7(3):41. doi: 10.21037/atm.2018.12.50.
Cemented, mobile-bearing unicondylar knee arthroplasty (UKA) yields good functional results. However, radiolucent lines (RLL) are not uncommon, even in asymptomatic patients, and it has been debated whether these "physiological" RLLs are indicative of loosening. Cementless UKA may lead to fewer RLLs compared with cemented devices. The present study was designed to document mid-term outcome with an emphasis on clinical outcomes.
We included 153 knees of 150 consecutive patients in a retrospective study. All patients had received a cementless medial mobile-bearing UKA. Patients were evaluated with use of the Knee Society Score (KSS), which was obtained at baseline and at final follow-up. The WOMAC, Oxford Knee Score (OKS) and Forgotten Joint Scores (FJS-12) were administered at the final follow-up. Anteroposterior (AP) and lateral radiographs were taken at final follow-up.
At a mean follow-up of 5 years (range, 3-7 years), implant survival was 97.1% (95% confidence interval, 91.1-99.1%). Excellent postoperative KSS, WOMAC, OKS and FJS scores were obtained. Postoperative radiography was available for 78 knees. RLL was observed in 10.3% of the cases, but no cases with complete RLLs were seen.
Favourable results were found for cementless, mobile-bearing UKA, with no aseptic loosening at an average follow-up of 5 years. Cementless UKA fixation may lead to a clinically "forgotten joint" and may decrease the rate of RLLs.
骨水泥型、活动平台单髁膝关节置换术（UKA）可产生良好的功能效果。然而，即使在无症状患者中，射线可透性线（RLL）也并不少见，并且这些“生理性”RLL是否提示松动一直存在争议。与骨水泥型假体相比，非骨水泥型UKA可能导致较少的RLL。本研究旨在记录中期结果，重点关注临床结局。
我们纳入了150例连续患者的153个膝关节进行回顾性研究。所有患者均接受了非骨水泥型内侧活动平台UKA。使用膝关节协会评分（KSS）对患者进行评估，该评分在基线和最终随访时获得。在最终随访时进行WOMAC、牛津膝关节评分（OKS）和遗忘关节评分（FJS-12）。在最终随访时拍摄前后位（AP）和侧位X线片。
平均随访5年（范围3 - 7年）时，假体生存率为97.1%（95%置信区间，91.1 - 99.1%）。术后获得了优异的KSS、WOMAC、OKS和FJS评分。78个膝关节有术后X线片。10.3%的病例观察到RLL，但未见完全RLL的病例。
非骨水泥型、活动平台UKA取得了良好的结果，平均随访5年无无菌性松动。非骨水泥型UKA固定可能导致临床上的“遗忘关节”，并可能降低RLL的发生率。
