Department of Orthopaedics, Trondheim University Hospital, Postbox 3250, NO 7006, Torgarden, Trondheim, Norway.
Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Knee Surg Sports Traumatol Arthrosc. 2022 Aug;30(8):2738-2743. doi: 10.1007/s00167-021-06617-5. Epub 2021 May 25.
In recent years, the preferred fixation method for unicompartmental knee arthroplasty (UKA) has changed from cemented to cementless. The aim of this study was to compare patient-reported outcome measures (PROMs) from the cemented versus cementless techniques two- and twelve-months post-operation.
From 2015 to 2019, 187 cemented and 261 cementless UKAs were included based on an institutional registry. The Oxford Unicompartmental Knee System™ (Zimmer Biomet, Bridgend, United Kingdom) was used for all patients. Three experienced surgeons performed all procedures. Data were collected pre- and peroperatively, and at two- and twelve-months postoperatively. PROMs included pain (evaluated on a numeric rating scale [NRS] during activity and at rest), and knee function (evaluated with the disease-specific short form of the Knee injury and Osteoarthritis Outcome Score [KOOS-PS]). Patients also rated postoperative joint function (better, unchanged, uncertain or worse) and were asked, "based on your experience to date, would you go through the surgery again?". Duration of surgery was noted and revisions during the first post-operative year were evaluated.
The cemented group reported significantly lower activity-related pain at both two- and twelve-month follow-up. This was also the case for pain at rest at twelve-month follow-up, and KOOS-PS at two-month follow-up. Duration of surgery (adjusted for surgeon differences) was eight minutes less on average with the cementless technique. Eleven prosthetic joint infections (PJIs) were found following the cementless fixation technique compared to three using the cemented implant.
UKA cases with cemented implants had lower pain scores during activity two and twelve months after surgery compared with those who had cementless implants. Differences in favor of the cemented group were also found for pain at rest one year after surgery and for KOOS-PS two months after. Surgery was significantly shorter in duration in the cementless group, but a relatively high number of PJIs were found in that same group.
Level II.
近年来，单髁膝关节置换术（UKA）的首选固定方式已由骨水泥固定改为非骨水泥固定。本研究旨在比较两种固定技术在术后 2 个月和 12 个月的患者报告结局测量（PROMs）。
根据机构登记处，2015 年至 2019 年共纳入 187 例骨水泥固定和 261 例非骨水泥固定 UKA。所有患者均使用牛津单髁膝关节系统™（Zimmer Biomet，Bridgend，英国）。由 3 位经验丰富的外科医生进行所有手术。数据在术前、术中和术后 2 个月及 12 个月收集。PROMs 包括疼痛（活动和休息时用数字评分量表[NRS]评估）和膝关节功能（用膝关节损伤和骨关节炎结果评分[KOOS-PS]的特定疾病短表评估）。患者还对术后关节功能进行评分（更好、不变、不确定或更差），并被问到“根据你目前的经验，你会再次接受手术吗？”。记录手术持续时间，并评估术后 1 年内的翻修情况。
骨水泥组在术后 2 个月和 12 个月随访时报告的活动相关疼痛明显较低。在术后 12 个月时休息时的疼痛和术后 2 个月时的 KOOS-PS 也是如此。非骨水泥技术的手术时间平均减少 8 分钟。与使用骨水泥固定的植入物相比，使用非骨水泥固定的植入物后发现 11 例假体关节感染（PJI），而使用骨水泥固定的植入物后发现 3 例。
与使用非骨水泥植入物的患者相比，使用骨水泥植入物的 UKA 患者在术后 2 个月和 12 个月时的活动时疼痛评分较低。在术后 1 年时休息时的疼痛和术后 2 个月时的 KOOS-PS 也发现了有利于骨水泥组的差异。非骨水泥组的手术时间明显缩短，但该组发现的假体关节感染（PJI）相对较多。
二级。
