对于同时接受单髁膝关节置换术和全膝关节置换术的个体，单髁膝关节是首选的一侧。
The unicompartmental knee is the preferred side in individuals with both a unicompartmental and total knee arthroplasty.
机构信息
Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, UK.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3193-3199. doi: 10.1007/s00167-019-05814-7. Epub 2019 Nov 28.
PURPOSE
To determine the preferred knee in patients with both one total and one unicompartmental knee arthroplasty.
METHOD
Patients simply with a unicompartmental (UKA) and total knee arthroplasty (TKA) on contralateral sides were retrospectively screened from three senior knee surgeon's logs over a 15 year period. Patients safe and free from other diseases to affect gait were approached. A total of 16 patients (mean age 70 ± 8) agreed to ground reaction force testing on an instrumented treadmill at a fair pace and incline. A gender-ratio identical group of 16 healthy control subjects (mean age 67 ± 10) and 16 patients with ipsilateral medial knee OA (mean age 66 ± 7) were analysed to compare.
RESULTS
Radiographically the mode preoperative Kellgren-Lawrence knee grade for each side was 3. Postoperatively, the TKA side had a mean coronal femoral component alignment of 7° and a mean tibial coronal alignment of 89° with a mean posterior slope of 5° in the sagittal plane. The UKA side had a mean coronal femoral component alignment of 7° and a mean tibial coronal alignment of 86° with a mean posterior slope of 4° in the sagittal plane. In 7 patients, the TKA was the first procedure, while 6 for the UKA and 3 done simultaneously. Gait analysis demonstrated in both walking conditions the UKA limb was the preferred side through all phases of loading (p < 0.05) and nearer to normal than the TKA limb when compared to healthy controls and patients with knee OA. The greatest difference was observed between the transition of weight acceptance and midstance (p = 0.008), when 22% more load was taken by the UKA side.
CONCLUSION
By using a dynamic metric of an everyday activity, a distinct gait difference between differing arthroplasty types were established. A more natural loading pattern can be achieved with unicompartmentals as compared to total knees.
LEVEL OF EVIDENCE
Retrospective comparative study, Level III.
目的
确定同时患有全膝关节置换术（TKA）和单髁膝关节置换术（UKA）的患者中，哪一侧膝关节为优势膝关节。
方法
从三位资深膝关节外科医生的 15 年手术日志中回顾性筛选出单纯单侧 UKA 和 TKA 的患者。对无其他影响步态疾病且身体状况允许的患者进行了评估。共有 16 名患者（平均年龄 70±8 岁）同意在配备仪器的跑步机上以适当的速度和坡度进行地面反力测试。分析了 16 名性别比例相同的健康对照组（平均年龄 67±10 岁）和 16 名同侧内侧膝关节骨关节炎（OA）患者的结果，以进行比较。
结果
影像学上，每侧术前 Kellgren-Lawrence 膝关节分级的模式为 3 级。术后，TKA 侧股骨冠状面组件平均对线为 7°，胫骨冠状面平均对线为 89°，矢状面平均后倾角度为 5°。UKA 侧股骨冠状面组件平均对线为 7°，胫骨冠状面平均对线为 86°，矢状面平均后倾角度为 4°。在 7 名患者中，TKA 是初次手术，而 UKA 则有 6 例，3 例同时进行。步态分析显示，在两种行走状态下，UKA 侧在所有负重阶段均为优势侧（p<0.05），与健康对照组和膝 OA 患者相比，更接近正常步态。在承重期和中期支撑期的过渡阶段（p=0.008）观察到最大的差异，此时 UKA 侧承受的负荷增加了 22%。
结论
通过使用日常活动的动态指标，确定了不同类型关节置换术之间明显的步态差异。与全膝关节置换术相比，单髁膝关节置换术可实现更自然的负重模式。
证据等级
回顾性比较研究，III 级。
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