The Third Department of Joint Orthopedics, The Third Hospital of Hebei Medical University, Hebei, China.
Medicine (Baltimore). 2021 Aug 13;100(32):e26825. doi: 10.1097/MD.0000000000026825.
Unicompartmental knee arthroplasty (UKA) is one of the commonly used surgical methods for unicompartmental osteoarthritis in recent years. Although the prognosis of the operated knee has been widely studied, there are relatively little data on the natural history of the contralateral knee after unilateral replacement. The aim of this study was to explore the incidence and risk factors of consequential knee arthroplasty in patients with bilateral knee osteoarthritis (KOA) after receiving primary unilateral UKA, so as to provide a theoretical basis for making a more comprehensive treatment strategy for patients with KOA.We conducted a retrospective study and enrolled patients with bilateral KOA received unilateral UKA from June 2015 to December 2019 in the third department of joint orthopedics, the third hospital of Hebei Medical University. The patients were divided into replacement group and non-replacement group according to whether the contralateral knee joint received knee arthroplasty. Information about treatment of contralateral knee joint was collected from medical records to determine the incidence. Univariate analysis and multivariate logistic regression analysis were performed to identify the independent risk factors.A total of 502 patients were enrolled in this study. The incidence of contralateral knee arthroplasty was 38.64%. In the univariate analysis, vertical angle of mechanical axis, knee joint's internal and external joint space, Kellgren-Lawrence (K-L) classification, femoral tibial angle were the significant risk factors for contralateral knee arthroplasty. In the multivariate model, only vertical angle of mechanical axis ≥3.03° (odds ratio [OR] 4.36, 95% confidence interval [CI], 2.47-9.11), K-L classification grades 3 and 4 (OR 2.46,3.72; 95%CI, 1.31-4.25, 1.98-6.87), and femoral tibial angle ≥187.32° (OR 6.32, 95%, 2.23-18.87) remained associated with the occurrence of knee arthroplasty.About a quarter of patients with bilateral KOA received unilateral UKA will receive contralateral knee arthroplasty. Higher K-L classification, femoral tibial angle, and mechanical axis vertical angle are identified risk factors.
单间膝关节置换术 (UKA) 是近年来治疗单间骨关节炎的常用手术方法之一。尽管已广泛研究了手术膝关节的预后，但有关单侧置换后对侧膝关节自然史的数据相对较少。本研究旨在探讨双侧膝关节骨关节炎 (KOA) 患者接受单侧 UKA 后继发膝关节置换的发生率和危险因素，为 KOA 患者制定更全面的治疗策略提供理论依据。
我们进行了一项回顾性研究，纳入了 2015 年 6 月至 2019 年 12 月在河北医科大学第三医院关节骨科三病区接受单侧 UKA 的双侧 KOA 患者。根据对侧膝关节是否接受膝关节置换，将患者分为置换组和非置换组。从病历中收集对侧膝关节治疗信息，确定发生率。采用单因素分析和多因素 logistic 回归分析确定独立危险因素。
共纳入 502 例患者，对侧膝关节置换发生率为 38.64%。单因素分析中，机械轴垂直角度、膝关节内外关节间隙、Kellgren-Lawrence (K-L) 分级、股胫角是对侧膝关节置换的显著危险因素。在多因素模型中，仅机械轴垂直角度≥3.03°(比值比[OR] 4.36，95%置信区间[CI]，2.47-9.11)、K-L 分级 3 级和 4 级(OR 2.46，3.72；95%CI，1.31-4.25，1.98-6.87)和股胫角≥187.32°(OR 6.32，95%，2.23-18.87)与膝关节置换的发生仍相关。
约四分之一接受双侧 KOA 单侧 UKA 的患者将接受对侧膝关节置换。较高的 K-L 分级、股胫角和机械轴垂直角度是确定的危险因素。
