Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, UK.
University of the West of England, Bristol, BS16 1QL, UK.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):800-808. doi: 10.1007/s00167-021-06454-6. Epub 2021 Jan 27.
The peri-operative and short-term benefits of unicompartmental knee arthroplasty (UKA) are well supported in the literature. However, there remains concern regarding the higher revision rate when compared with total knee replacement. This manuscript reports the functional outcome and survivorship of a large series of fixed bearing, medial unicompartmental replacements (St Georg Sled), with a minimum of 20 years follow-up.
Between 1974 and 1994, 399 patients (496 knees) underwent a medial fixed-bearing UKA. Prospective data were collected pre-operatively and at regular intervals post-operatively using the Bristol Knee Score (BKS), Oxford Knee (OKS) and Western Ontario MacMaster (WOMAC) scores. Kaplan-Meier survival analysis was used to determine survivorship, with revision or need for revision as end point, and differences assessed using Mantel-Cox log rank test.
Functional knee scores improved post-operatively, but demonstrated a slight decline from 10 years of follow-up onwards. Survivorship is estimated as 86% at 10 years, 80% at 15 years, and 78% at 20 years. Sixty knees were revised, with progression of disease in another compartment the commonest reason. Eighty eight percent were revised using a primary prosthesis. For patients over the age of 65 years at the time of index procedure, 93% died with a functioning prosthesis in situ.
Medial UKA demonstrates good long-term function and survivorship, and represents an excellent surgical option for patients aged over 65 years of age, where few patients will require a revision procedure.
IV.
单髁膝关节置换术（UKA）的围手术期和短期益处已在文献中得到充分证实。然而，与全膝关节置换相比，其翻修率仍然较高。本文报告了大量固定衬垫、内侧单髁置换（St Georg Sled）的功能结果和存活率，随访时间至少 20 年。
1974 年至 1994 年期间，399 例（496 膝）患者接受了内侧固定衬垫 UKA。使用 Bristol Knee Score（BKS）、Oxford Knee（OKS）和 Western Ontario MacMaster（WOMAC）评分在术前和术后定期收集前瞻性数据。使用 Kaplan-Meier 生存分析来确定生存率，以翻修或需要翻修为终点，并使用 Mantel-Cox 对数秩检验评估差异。
膝关节功能评分在术后得到改善，但从 10 年随访开始略有下降。预计 10 年生存率为 86%，15 年生存率为 80%，20 年生存率为 78%。60 个膝关节需要翻修，另一个间隔的疾病进展是最常见的原因。88%的患者使用初次假体进行了翻修。对于指数手术时年龄超过 65 岁的患者，93%的患者在原位有功能的假体死亡。
内侧 UKA 具有良好的长期功能和存活率，是 65 岁以上患者的极佳手术选择，很少有患者需要进行翻修手术。
IV。
