Nandra R, Rajgor H D, Winkworth C, Aslam N
Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD, UK.
J Clin Orthop Trauma. 2021 Mar 20;17:176-181. doi: 10.1016/j.jcot.2021.03.012. eCollection 2021 Jun.
Uncemented unicompartmental knee replacement offers a minimally invasive approach, faster rehabilitation and good levels of function, supported by evidence reporting low intra-operative fracture rate and mid-term stability with no implant migration at 5-years. Our aim was to examine the clinical outcomes in 289 consecutive Oxford unicompartmental knee arthroplasties (257 patients), five years post-operatively.
A retrospective study of patients treated between 2008 and 2014 in a non-inventor centre by a single surgeon was performed. Patients with anteromedial bone on bone uni-compartmental arthritis were included. Oxford Knee Scores (OKSs) at last follow-up were recorded, intra-operative complications reported with commentary on revision cases.
Mean age of patients was 66 years (SD 9.6, 45-88 years). 122 (42%) patients were female and 135 (58%) were male. Patient in our study were ASA 1 (36%), ASA 2 (62%) and ASA 3 (01%). There were no intra-operative complications, particularly tibia fractures during impaction. The average oxford knee score was 40.1 (n = 232, Range 06 to 48, SD 8.46) at an average 6 years and 3 months from surgery, including revised patients. Six patients had their prosthesis revised within five-years of the index surgery. Five-year cumulative implant survival rate was 97.8% (95% CI 97.62 to 97.98, SE 0.09). Indications for revision were: lateral side wear (n = 1); dislocated spacer (n = 4); instability and spacer subluxation (n = 1). Thirteen patients died within five years of surgery Five-year cumulative survival rate was 94.9% (95% CI 94.87 to 94.925, SE 0.013).
The proportion of patients requiring revision at five-years is lower than that generally reported for UKR. These findings add support for the use of the cementless oxford UKR outside the design centre.
非骨水泥单髁膝关节置换术提供了一种微创方法，康复更快且功能良好，有证据表明术中骨折率低，中期稳定性好，5年时无植入物移位。我们的目的是研究289例连续接受牛津单髁膝关节置换术（257例患者）术后5年的临床结果。
对2008年至2014年在一个非发明中心由一名外科医生治疗的患者进行回顾性研究。纳入前内侧骨对骨单髁关节炎患者。记录最后一次随访时的牛津膝关节评分（OKS），报告术中并发症并对翻修病例进行评论。
患者的平均年龄为66岁（标准差9.6，45 - 88岁）。122例（42%）患者为女性，135例（58%）为男性。我们研究中的患者美国麻醉医师协会（ASA）分级为1级（36%）、2级（62%）和3级（1%）。术中无并发症，尤其是在打压过程中未发生胫骨骨折。在平均距手术6年3个月时（包括翻修患者），平均牛津膝关节评分为40.1（n = 232，范围06至48，标准差8.46）。6例患者在初次手术的5年内进行了假体翻修。5年累计植入物生存率为97.8%（95%置信区间97.62至97.98，标准误0.09）。翻修的指征为：外侧磨损（n = 1）；间隔器脱位（n = 4）；不稳定和间隔器半脱位（n = 1）。有13例患者在术后5年内死亡。5年累计生存率为94.9%（95%置信区间94.87至94.925，标准误0.013）。
5年时需要翻修的患者比例低于一般报道的单髁膝关节置换术的比例。这些发现为在设计中心以外使用非骨水泥牛津单髁膝关节置换术提供了支持。
