Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7LD, UK.
Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Level 1 Learning and Research Building, Southmead Hospital, Westbury-On-Trym, Bristol, BS10 5NB, UK.
Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):928-938. doi: 10.1007/s00167-020-06428-0. Epub 2021 Feb 12.
Unicompartmental Knee Replacements (UKR) are being performed in patients with increasing demands and life expectancies with surgical concerns that cemented fixation will not last. Cementless fixation may offer a solution, but the results in different age groups have not been assessed. The effect of age at surgery on the outcomes of cementless UKRs was investigated.
A prospective cohort of 1000 medial cementless mobile bearing UKR were analysed. Patients were categorised into four age groups (< 55, 55 to < 65, 65 to < 75 and ≥ 75 years). Implant survival was assessed using endpoints reoperation, revision and major revision requiring revision knee replacement components. Functional outcomes were assessed.
10 year cumulative revision rate for the < 55, 55 to < 65, 65 to < 75 and ≥ 75 groups were 2.1% (CI 0.6-6.1), 1.8% (CI 0.6-5.3), 3.2% (CI 1.5-6.5) and 4.1% (1.7-9.6) with no differences between groups (p = 0.52). Two of the 22 revisions were considered major. The 10 year cumulative reoperation rates were 4.5% (CI 2.0-10.0), 3.0% (CI 1.3-6.5), 3.8% (CI 2.0-7.1) and 4.1% (CI 1.7-9.6) with no differences between groups (p = 0.81). The 10 year median Oxford Knee Scores were 42.5, 46.5, 45 and 42.5, respectively. The 10 year median Objective American Knee Society Scores were 95 for all age groups.
The cementless mobile bearing UKR has low reoperation and revision rates and similar functional outcomes in all age groups. Cementless UKR should be used in all age groups and age should not be considered a contraindication.
III.
随着人们对生活质量的要求不断提高，预期寿命也在延长，因此接受单髁膝关节置换术（UKR）的患者也越来越多。人们越来越担心，用骨水泥固定的膝关节假体的使用寿命不会太长。非骨水泥固定可能是一种解决方案，但不同年龄组的结果尚未得到评估。本研究旨在探讨手术时的年龄对非骨水泥 UKR 结果的影响。
前瞻性分析了 1000 例内侧非骨水泥活动衬垫单髁膝关节置换患者的资料。患者分为 4 个年龄组（＜55 岁、55 岁至＜65 岁、65 岁至＜75 岁和≥75 岁）。使用再手术、翻修和需要翻修膝关节置换组件的主要翻修作为终点，评估假体的生存率。同时评估功能结果。
＜55 岁、55 岁至＜65 岁、65 岁至＜75 岁和≥75 岁组的 10 年累积翻修率分别为 2.1%（95%CI 0.6-6.1）、1.8%（95%CI 0.6-5.3）、3.2%（95%CI 1.5-6.5）和 4.1%（95%CI 1.7-9.6），组间差异无统计学意义（p=0.52）。22 次翻修中有 2 次被认为是主要翻修。10 年累积再手术率分别为 4.5%（95%CI 2.0-10.0）、3.0%（95%CI 1.3-6.5）、3.8%（95%CI 2.0-7.1）和 4.1%（95%CI 1.7-9.6），组间差异无统计学意义（p=0.81）。10 年时 Oxford 膝关节评分中位数分别为 42.5、46.5、45 和 42.5。10 年时客观美国膝关节学会评分中位数均为 95。
非骨水泥活动衬垫 UKR 具有较低的再手术率和翻修率，在所有年龄组中均具有相似的功能结果。非骨水泥 UKR 可用于所有年龄组，年龄不应作为禁忌证。
III 级。
