Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza, Brescia, Italy.
Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Bone Joint J. 2021 May;103-B(5):840-845. doi: 10.1302/0301-620X.103B5.BJJ-2020-0720.R3.
In the last decade, interest in partial knee arthroplasties and bicruciate retaining total knee arthroplasties has increased. In addition, patient-related outcomes and functional results such as range of movement and ambulation may be more promising with less invasive procedures such as bicompartmental arthroplasty (BCA). The purpose of this study is to evaluate clinical and radiological outcomes after a third-generation patellofemoral arthroplasty (PFA) combined with a medial or lateral unicompartmental knee arthroplasty (UKA) at mid- to long-term follow-up.
A total of 57 procedures were performed. In 45 cases, a PFA was associated with a medial UKA and, in 12, with a lateral UKA. Patients were followed with validated patient-reported outcome measures (Oxford Knee Score (OKS), EuroQol five-dimension questionnaire (EQ-5D), EuroQoL Visual Analogue Scale (EQ-VAS)), the Knee Society Score (KSS), the Forgotten Joint Score (FJS), and radiological analysis.
The mean follow-up was nine years (6 to 13). All scores significantly improved from preoperatively to final follow-up (mean and SD): OKS from 23.2 (8.1) to 42.5 (3.5), EQ-5D from 0.44 (0.25) to 0.815 (0.1), EQ-VAS from 46.7 (24.9) to 89.1 (9.8), KSS (Knee) from 51.4 (8.5) to 94.4 (4.2), and KSS (Function) from 48.7 (5.5) to 88.8 (5.2). The mean FJS at final follow-up was 79.2 (4.2). All failures involved the medial UKA + PFA group. Overall, survival rate was 91.5% for all the combined implants at ten years with 95% confidence intervals and 22 knees at risk.
Excellent clinical and radiological outcomes were achieved after a third-generation PFA combined with a medial or lateral UKA. BCA with unlinked partial knee prostheses showed a good survival rate at mid- to long-term follow-up. Cite this article: 2021;103-B(5):840-845.
在过去十年中，对部分膝关节置换术和保留双交叉韧带的全膝关节置换术的兴趣有所增加。此外，与侵入性较小的手术（如双间室膝关节置换术[BCA]）相比，患者相关的结果和功能结果（如活动范围和步行能力）可能更有希望。本研究的目的是评估第三代髌股关节置换术（PFA）联合内侧或外侧单间室膝关节置换术（UKA）在中期至长期随访时的临床和影像学结果。
共进行了 57 例手术。在 45 例中，PFA 与内侧 UKA 联合使用，在 12 例中，与外侧 UKA 联合使用。患者采用经过验证的患者报告结果测量（牛津膝关节评分[OKS]、欧洲五维健康量表问卷[EQ-5D]、欧洲五维健康量表视觉模拟量表[EQ-VAS]）、膝关节学会评分（KSS）、遗忘关节评分（FJS）和影像学分析进行随访。
平均随访时间为 9 年（6 至 13 年）。所有评分均从术前到最终随访时显著改善（均值和标准差）：OKS 从 23.2（8.1）改善至 42.5（3.5），EQ-5D 从 0.44（0.25）改善至 0.815（0.1），EQ-VAS 从 46.7（24.9）改善至 89.1（9.8），KSS（膝关节）从 51.4（8.5）改善至 94.4（4.2），KSS（功能）从 48.7（5.5）改善至 88.8（5.2）。最终随访时的平均 FJS 为 79.2（4.2）。所有失败均涉及内侧 UKA+PFA 组。总体而言，10 年时所有联合植入物的生存率为 91.5%，置信区间为 95%，有 22 个膝关节存在风险。
第三代 PFA 联合内侧或外侧 UKA 可获得良好的临床和影像学结果。中期至长期随访时，非链接式部分膝关节假体的 BCA 显示出良好的生存率。
2021；103-B（5）：840-845.
