IRCCS Orthopedic Institute Galeazzi, Milan, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):890-898. doi: 10.1007/s00167-021-06467-1. Epub 2021 Feb 7.
To compare the rate of return to sports and body mass index (BMI) reduction in patients who underwent surgery for unicompartmental knee arthroplasty (UKA) with either Cobalt-Chromium (CoCr) alloy UKA or with hypoallergenic UKA, stratified by age, gender and BMI.
Two consecutive cohorts of patients with a total of 172 UKA and a minimum 2-year follow-up period were prospectively included in this comparative study. The first cohort consisted of 136 consecutive series of standard Cobalt-Chromium (CoCr Group). The second cohort consisted of 36 consecutive mobile-bearing hypoallergenic Titanium Niobium Nitride UKA, (TiNbN Group). The clinical evaluation was based on the University of California, Los Angeles (UCLA) activity scores and the High-Activity Arthroplasty Score (HAAS) evaluated on the day before surgery (T) and after a minimum follow-up of 12 months (T) and 24 months (T). Radiographic evaluation performed at T included the femoral component position in varus/valgus, the tibial component in varus/valgus and the anteroposterior slope.
No statistical differences were found between the groups at each follow-up, as shown by the UCLA and HAAS score (n.s.). Both groups showed a statistically significant improvement (p < 0.05) at each follow-up. Both groups showed a statistically significant BMI reduction between T and T (p < 0.05). Radiographic analysis revealed no statistical differences between the two groups in terms of the three measures after the final follow-up (n.s.). All the subgroups showed a significant (p < 0.05) rate of return to sport if compared with the preoperative value (T versus T), except for male in TiNbN group.
Both TiNbN and CoCr medial mobile-bearing UKA enabled patients to return to sports after the final follow-up, regardless of age, BMI, gender and metal sensitivity. These findings inform shared decision making and can help to manage patient expectations after surgery, in particular, in active patients with an overt metal allergy, a specific hypoallergenic implant should be considered the gold standard implant in partial knee replacement surgery.
Cohort Study, Level III.
researchregistry6250- www.researchregistry.com .
比较行单髁膝关节置换术（UKA）的患者在钴铬合金（CoCr）UKA 或低致敏 UKA 治疗后重返运动的比率和体重指数（BMI）降低率，按年龄、性别和 BMI 分层。
本前瞻性比较研究连续纳入了两批共 172 例 UKA 患者，随访时间至少 2 年。第一组为 136 例连续钴铬合金（CoCr 组）系列。第二组为 36 例连续的钛铌氮化物移动轴承低致敏 UKA，（TiNbN 组）。临床评估基于加利福尼亚大学洛杉矶分校（UCLA）活动评分和高活动人工关节评分（HAAS），在术前（T）和至少 12 个月（T）和 24 个月（T）随访后进行评估。T 时进行的放射学评估包括股骨组件在内翻/外翻、胫骨组件在内翻/外翻和前后倾斜的位置。
在每个随访时，两组之间均未发现统计学差异，UCLA 和 HAAS 评分无差异（n.s.）。两组在每个随访时均显示出统计学显著改善（p<0.05）。两组在 T 与 T 之间均显示出 BMI 统计学显著降低（p<0.05）。在最终随访后，两组在三个测量指标方面均无统计学差异（n.s.）。所有亚组与术前值（T 与 T）相比，均显示出显著（p<0.05）的重返运动率，除 TiNbN 组男性外。
TiNbN 和 CoCr 内侧移动轴承 UKA 均可使患者在最终随访后重返运动，无论年龄、BMI、性别和金属敏感性如何。这些发现为共同决策提供了信息，并有助于管理术后患者的期望，特别是在有明显金属过敏的活跃患者中，应将特定的低致敏植入物视为部分膝关节置换手术的金标准植入物。
队列研究，III 级。
researchregistry6250-www.researchregistry.com。
