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在非骨水泥 Oxford 活动平台单髁膝关节置换术中,由于胫骨组件定位不当导致胫骨组件内翻下沉。

Valgus Subsidence of the Tibial Component Caused by Tibial Component Malpositioning in Cementless Oxford Mobile-Bearing Unicompartmental Knee Arthroplasty.

机构信息

Department of Orthopaedic Surgery and Joint Surgery Center, Takatsuki General Hospital, Takatsuki, Osaka, Japan; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Orthopaedic Surgery and Joint Surgery Center, Takatsuki General Hospital, Takatsuki, Osaka, Japan.

出版信息

J Arthroplasty. 2019 Dec;34(12):3054-3060. doi: 10.1016/j.arth.2019.07.006. Epub 2019 Jul 16.

DOI:10.1016/j.arth.2019.07.006
PMID:31378509
Abstract

BACKGROUND

Valgus subsidence (VS) of the tibial component is a rare complication of unicompartmental knee arthroplasty (UKA), and surgeons might consider revision surgery. The present study aimed to identify the factors related to VS of the tibial component after cementless Oxford mobile-bearing UKA.

METHODS

The study included 120 patients who underwent Oxford mobile-bearing UKA using a cementless tibial component in our center between September 2015 and September 2016. Six showed VS of >2° after surgery. Patients were stratified into 2 groups according to the occurrence of VS of the tibial component (VS group, n = 6; no-subsidence group, n = 114). Postoperative radiographic evaluations were conducted to assess the varus/valgus alignment, rotation, and mediolateral position of the tibial and femoral components. The Oxford Knee Score (OKS) was assessed at 3, 6, and 12 months postoperatively. Positional parameters and sequential change in OKS were compared between the two groups using unpaired t-test (P < .05, statistically significant).

RESULTS

At 3 months postoperatively, an average VS of 3.4° in the VS group was observed, with a significant decrease in OKS. VS was associated with a significantly more medial position and external rotation of the tibial component. After 3 months, VS stopped, and the OKS gradually improved without revision surgery.

CONCLUSIONS

VS might be caused by the malpositioning of the tibial component. VS of the tibial component after UKA appears to stop, with simultaneous pain relief, even without revision after 3 months postoperatively.

摘要

背景

胫骨组件内翻沉降(VS)是单间室膝关节置换术(UKA)的罕见并发症,外科医生可能会考虑进行翻修手术。本研究旨在确定与非骨水泥 Oxford 活动衬垫 UKA 后胫骨组件 VS 相关的因素。

方法

本研究纳入了 2015 年 9 月至 2016 年 9 月期间在我中心接受非骨水泥 Oxford 活动衬垫 UKA 的 120 例患者。其中 6 例术后出现 VS>2°。根据胫骨组件 VS 的发生情况将患者分为 2 组(VS 组,n=6;无沉降组,n=114)。术后进行放射学评估,以评估胫骨和股骨组件的内翻/外翻对线、旋转和内外侧位置。术后 3、6 和 12 个月分别评估牛津膝关节评分(OKS)。使用未配对 t 检验比较两组之间的位置参数和 OKS 的连续变化(P<0.05,具有统计学意义)。

结果

术后 3 个月,VS 组出现平均 3.4°的 VS,OKS 显著下降。VS 与胫骨组件的明显内侧位置和外旋有关。3 个月后,VS 停止,OKS 逐渐改善,无需进行翻修手术。

结论

VS 可能是由胫骨组件的定位不当引起的。UKA 后胫骨组件的 VS 似乎停止,同时疼痛缓解,即使在术后 3 个月不进行翻修。

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