Department of Orthopaedic Surgery, Center for Osteonecrosis and Joint Preserving & Reconstruction, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing 100029, China.
Department of Orthopaedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.
Orthop Traumatol Surg Res. 2021 May;107(3):102802. doi: 10.1016/j.otsr.2021.102802. Epub 2021 Jan 8.
UKA has been proved to offer good results in treating patients with unicompartmental knee osteoarthritis (OA). However, there is still a controversy about the better fixation mode in UKA procedure between cemented and uncemented prosthesis. Therefore, this meta-analysis was conducted to compare clinical and radiological outcomes of cemented versus uncemented Oxford UKA.
The study surmised that uncemented Oxford UKA was associated with shorter operation time, higher function scores, lower revision rate and less radiolucency than cemented Oxford UKA.
A meta-analysis to compare postoperative outcomes between cemented and uncemented Oxford UKA wsa conducted. The primary outcomes included Oxford knee score (OKS), revision rate, and incidence of radiolucency. The secondary outcomes included operation time, knee society score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM). PubMed, Embase, Web of Science, the Cochrane Library and China national knowledge infrastructure were searched until April, 2020 to identify studies for including. Relevant data were analyzed using RevMan v5.3.
We identified nine studies involving 901 patients meeting our inclusion criteria. No significant difference of OKS was found in both groups. Compared with cemented group, uncemented Oxford UKA group was associated with lower revision rate (95% CI: 0.90 to 3.73; OR=1.83) and less radiolucent lines (95% CI: 0.79 to 9.52; OR=2.75) after following up for at least 2years. The operation time was significantly shorter by 10.12minutes (95% CI: p<0.00001) in the uncemented group when compared against the cemented group. The KSS, WOMAC, ROM were not significantly different between two groups.
Uncemented Oxford UKA had lower revision rate, shorter operation time and less radiolucent lines than cemented Oxford UKA did. There is still need for more long follow-up clinical trials with high evidence level to determine which method of fixation is of preferable for Oxford UKA in the future.
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UKA 已被证明可用于治疗单间室膝骨关节炎（OA）患者，效果良好。然而，在 UKA 手术中，骨水泥固定与非骨水泥固定假体之间哪种固定方式更好，仍存在争议。因此，进行了这项荟萃分析，以比较骨水泥固定与非骨水泥固定牛津 UKA 的临床和影像学结果。
本研究推测，与骨水泥固定的牛津 UKA 相比，非骨水泥固定的牛津 UKA 具有更短的手术时间、更高的功能评分、更低的翻修率和更少的放射性透亮线。
对骨水泥固定和非骨水泥固定牛津 UKA 术后结果进行荟萃分析。主要结果包括牛津膝关节评分（OKS）、翻修率和放射性透亮线发生率。次要结果包括手术时间、膝关节学会评分（KSS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、关节活动度（ROM）。检索 PubMed、Embase、Web of Science、Cochrane 图书馆和中国国家知识基础设施，直到 2020 年 4 月，以确定纳入的研究。使用 RevMan v5.3 分析相关数据。
我们确定了 9 项符合纳入标准的研究，共纳入 901 例患者。两组 OKS 无显著差异。与骨水泥组相比，至少随访 2 年，非骨水泥牛津 UKA 组的翻修率（95%CI：0.90 至 3.73；OR=1.83）和放射性透亮线（95%CI：0.79 至 9.52；OR=2.75）较低。非骨水泥组的手术时间明显短 10.12 分钟（95%CI：p<0.00001）。两组 KSS、WOMAC、ROM 无显著差异。
非骨水泥固定的牛津 UKA 与骨水泥固定的牛津 UKA 相比，具有更低的翻修率、更短的手术时间和更少的放射性透亮线。仍需要更多具有较高证据水平的长期随访临床试验来确定在未来牛津 UKA 中哪种固定方法更可取。
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