Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, UK, OX3 7LD.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, UK, OX3 7LD.
Orthop Traumatol Surg Res. 2020 May;106(3):443-447. doi: 10.1016/j.otsr.2019.11.012. Epub 2020 Apr 4.
The effect of age on the percentage of primary knee replacements appropriate for unicompartmental replacement (UKR), defined as candidacy, is unknown. The aim was to determine the candidacy and outcome of UKR in different age groups.
Age is associated with candidacy for medial UKR.
This cross-sectional study determined UKR candidacy from preoperative radiographs, including stress views, from 457 consecutive knee replacements (TKR or UKR) in a specialist joint replacement centre. Candidacy, estimated from radiographs and from usage, was determined for all knees and then stratified by age group<50, 50-60, 60-70, 70-80, and 80+. The outcome of UKR implanted in these groups was also assessed. To avoid overestimating, candidacy estimated by usage was used for the primary analysis.
Candidacy decreased with age (OR 0.98, p=0.008) and was 61% (CI 42-78), 52% (CI 43-61), 43% (CI 35-51), 41% (CI 31-52), and 36% (CI 22-52) respectively. Candidacy estimated by radiographs was slightly higher overall (49% compared to 46%) and in all age groups than candidacy estimated from usage. Neither functional outcome (p=0.47) nor implant survival (p=0.54) was affected by age. Overall 80% achieved good/excellent Knee Society objective scores, and the five-year implant survival was 99%.
There is a strong association of candidacy for UKR with age in that younger patients are more likely to be candidates (61% in those<50 and 36% in those 80+). Good outcomes can be expected in patients of all ages who are appropriate for UKR.
IV, Prognostic cross-sectional study.
年龄对单髁膝关节置换术（UKR）适应证（即候选性）的影响尚不清楚。本研究旨在确定不同年龄段 UKR 的候选性和结果。
年龄与内侧 UKR 的候选性相关。
本回顾性研究通过术前 X 线（包括应力位片）确定了来自专门关节置换中心的 457 例连续膝关节置换术（TKR 或 UKR）的 UKR 候选性。从 X 线和使用情况两个方面确定了所有膝关节的候选性，然后按年龄<50 岁、50-60 岁、60-70 岁、70-80 岁和 80+岁分组。还评估了这些组中植入的 UKR 的结果。为避免高估，使用使用情况估计的候选性进行了主要分析。
候选性随年龄下降（OR 0.98，p=0.008），分别为 61%（CI 42-78）、52%（CI 43-61）、43%（CI 35-51）、41%（CI 31-52）和 36%（CI 22-52）。总体而言，X 线估计的候选性略高（49%比 46%），且在所有年龄组中均高于使用情况估计的候选性。年龄对功能结果（p=0.47）和植入物生存率（p=0.54）均无影响。总体上 80%的患者获得了良好/优秀的膝关节协会客观评分，5 年的植入物生存率为 99%。
UKR 的候选性与年龄密切相关，年轻患者更有可能成为候选者（<50 岁的患者为 61%，80 岁以上的患者为 36%）。对于适合 UKR 的所有年龄段的患者，都可以预期获得良好的结果。
IV，预后性横断面研究。
