Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road Academia Building Level 4, Singapore 119228, Singapore.
Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road Academia Building Level 4, Singapore 119228, Singapore.
Knee. 2020 Dec;27(6):1914-1922. doi: 10.1016/j.knee.2020.08.013. Epub 2020 Nov 19.
A sizeable proportion of knee osteoarthritis is limited to the medial and patellofemoral compartments. Whilst short- and medium-term studies comparing bicompartmental knee arthroplasty (BCA) and total knee arthroplasty (TKA) have shown similar outcome scores, there are no studies comparing long-term outcomes. This study aims to determine which procedure resulted in superior long-term outcome scores.
Forty-eight patients with medial and patellofemoral compartment knee osteoarthritis were randomised to receive treatment in two groups: unlinked, modular BCA and TKA. The main outcome measures compared were the range of motion, Knee Society Function Score, Knee Society Knee Score, Oxford Knee Score, Physical Component Score and Mental Component Score of SF-36 pre-operatively and post-operatively up to 10 years. Radiographs of the operated knees were taken pre-operatively, post-operatively and at 10-year follow-up.
Twenty-six underwent BCA and 22 underwent TKA. Overall improvement was seen in both groups compared to pre-operatively, however there were no significant differences detected between the groups at 10 years. The median Hip-Knee-Ankle (HKA) angle was 183.38 (175.17-187.94) in the BCA group and 180.73 (174.96-185.65) in the TKA group. One patient from the BCA group had a peri-prosthetic fracture necessitating revision surgery to a TKA.
Outcome scores for BCA results were comparable to TKA at long-term follow-up. BCA is an alternative arthroplasty option in selected patients.
相当一部分膝关节骨关节炎仅限于内侧和髌股关节间室。虽然比较双间室膝关节置换术（BCA）和全膝关节置换术（TKA）的短期和中期研究显示出相似的结果评分，但没有研究比较长期结果。本研究旨在确定哪种手术方法产生了更好的长期结果评分。
48 例内侧和髌股关节间室膝关节骨关节炎患者随机分为两组接受治疗：非连接式、模块化 BCA 和 TKA。主要比较的结果测量指标是术前和术后至 10 年的关节活动度、膝关节学会功能评分、膝关节学会膝关节评分、牛津膝关节评分、SF-36 的生理成分评分和心理成分评分。对手术膝关节拍摄术前、术后和 10 年随访的 X 线片。
26 例患者接受 BCA，22 例患者接受 TKA。与术前相比，两组患者的整体改善情况均有所改善，但在 10 年时未发现两组之间存在显著差异。BCA 组的中位数髋膝踝角为 183.38（175.17-187.94），TKA 组为 180.73（174.96-185.65）。BCA 组有 1 例患者发生假体周围骨折，需要翻修为 TKA。
BCA 的长期随访结果评分与 TKA 相当。BCA 是一种替代关节置换术的选择，适用于特定患者。
