S. Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, 00186, Rome, Italy.
Int Orthop. 2021 Dec;45(12):3063-3068. doi: 10.1007/s00264-021-05031-3. Epub 2021 Apr 20.
While considered a satisfactory solution, unicompartmental knee arthroplasty (UKA) still raises concerns in regard to its durability. These concerns particularly focus on the tibial component. This study aims to compare two different cemented tibial components belonging to the same UKA design: all polyethylene (AP) versus metal backed (MB), at a long-term follow-up.
We retrospectively reviewed 143 successive patients, 83 of which underwent surgery with AP tibial component UKA (37 males, 46 females), and 67 with MB ones (17 males, 50 females). All implants had the same prosthetic design (Accuris UKA, Smith e Nephew) with identical femoral oxinium component but different tibial component, AP or MB. The KSS and KOOS were assessed at a mean of 11.5-year follow-up and compared to pre-operative, post-operative, and one year evaluation. Statistical analysis was performed with SPSS for Mac (version 17.0). To assess potential statistically significant differences, t test was used and significance was set at P < 0.05.
Final KSS at a mean of 11.5-year follow-up was 94.27 for the AP group and 96.12 for the MB ones. The final KOOS was 87 for AP components and 89.67 for the MB group. These results demonstrated, in all cases, statistically significant better results for MB tibial components compared to AP regarding KSS (P = 0.048), KOOS (P = 0.000), and pain (P = 0.014) at the 11.5-year follow-up. Survivorship for AP tibial component implants was 97.6%, while it was 89.5% for MB ones.
While the survivorship rate has been found to be greater for AP implants compared to MB tibial components, this study reveals statistically better functional results according to KSS and KOOS, and pain, at a long-term follow-up for MB implants.
尽管单髁膝关节置换术（UKA）被认为是一种满意的解决方案，但它的耐久性仍存在一些问题。这些问题主要集中在胫骨组件上。本研究旨在比较两种不同的同种 UKA 设计的骨水泥固定胫骨组件：全聚乙烯（AP）与金属背衬（MB），并进行长期随访。
我们回顾性分析了 143 例连续患者，其中 83 例接受了 AP 胫骨组件 UKA 手术（37 例男性，46 例女性），67 例接受了 MB 胫骨组件 UKA 手术（17 例男性，50 例女性）。所有植入物均采用相同的假体设计（Accuris UKA，Smith e Nephew），具有相同的股骨 oxinium 组件，但胫骨组件不同，为 AP 或 MB。在平均 11.5 年的随访时，采用 KSS 和 KOOS 进行评估，并与术前、术后和 1 年评估进行比较。使用 SPSS for Mac（版本 17.0）进行统计分析。为了评估潜在的统计学显著差异，使用 t 检验，显著性水平设为 P < 0.05。
在平均 11.5 年的随访时，AP 组的最终 KSS 为 94.27，MB 组为 96.12。AP 组的最终 KOOS 为 87，MB 组为 89.67。这些结果表明，在所有情况下，MB 胫骨组件在 KSS（P = 0.048）、KOOS（P = 0.000）和疼痛（P = 0.014）方面的结果均明显优于 AP，具有统计学意义。AP 胫骨组件的生存率为 97.6%，而 MB 胫骨组件的生存率为 89.5%。
虽然 AP 植入物的生存率高于 MB 胫骨组件，但本研究表明，在长期随访中，MB 植入物在 KSS 和 KOOS 以及疼痛方面的功能结果具有统计学意义的优势。
