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评价单间室膝关节置换术短期疗效的适当时机。

Appropriate Timing for Evaluation of the Short-Term Effectiveness of Unicompartmental Knee Arthroplasty.

机构信息

Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan.

出版信息

J Knee Surg. 2021 Jul;34(8):864-869. doi: 10.1055/s-0039-3402480. Epub 2019 Dec 30.

DOI:10.1055/s-0039-3402480
PMID:31887763
Abstract

Satisfactory results have been achieved with unicompartmental knee arthroplasty (UKA) for the treatment of isolated unicompartmental knee disease. However, UKA is associated with a significantly higher rate of revision. There is a tendency toward early revision of UKA for persistent pain because surgeons are not aware that outcomes can spontaneously improve with time. The aim of this study was to identify the time period that patients achieved the highest clinical outcomes following UKA. In total, we examined 72 knees that underwent Oxford UKA. We evaluated the range of motion and clinical results including Knee Society Knee Score, Knee Society Function Score (KSFS), and patient-reported scores using the Knee injury and Osteoarthritis Outcome Score (KOOS) at 1, 2, and 3 years postoperatively. The extension angle showed significant recovery from 1 to 2 years postoperatively, but no significant recovery was observed between 2 and 3 years. The flexion angle at 2 years is larger than at 1 year. The KSFS at 3 years is significantly lower than that at 1 year. The KOOS subscale of activities of daily living showed no significant differences among three periods after operation. The subscales of pain, symptom, sports, and quality of life showed significant recovery from 1 to 2 years postoperatively, but no significant recovery was observed from 2 to 3 years. To evaluate the effectiveness of Oxford UKA, surgeons should obtain clinical outcomes 2 years after the operation.

摘要

单髁膝关节置换术 (UKA) 治疗单间室膝关节疾病已取得满意效果。然而,UKA 与更高的翻修率相关。由于外科医生不知道结果会随着时间的推移而自发改善,因此 UKA 存在持续疼痛的早期翻修倾向。本研究旨在确定 UKA 后患者获得最高临床效果的时间。我们共检查了 72 例接受牛津 UKA 的膝关节。我们评估了运动范围和临床结果,包括膝关节协会膝关节评分(Knee Society Knee Score,KSKS)、膝关节协会功能评分(Knee Society Function Score,KSFS)和患者使用膝关节损伤和骨关节炎结果评分(Knee injury and Osteoarthritis Outcome Score,KOOS)报告的评分,分别在术后 1、2 和 3 年进行评估。术后 1 至 2 年,伸展角度有显著恢复,但 2 至 3 年之间没有显著恢复。2 年时的屈曲角度大于 1 年。3 年时的 KSFS 显著低于 1 年。术后三个时期的日常生活活动子量表的 KOOS 没有显著差异。疼痛、症状、运动和生活质量子量表在术后 1 至 2 年有显著恢复,但在 2 至 3 年之间没有显著恢复。为了评估牛津 UKA 的有效性,外科医生应该在手术后 2 年获得临床结果。

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