Wu H, Pan L P, Liu H, Wang H B, Ning T G, Cao Y P
Department of Orthopedics, Peking University First Hospital, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Oct 18;53(5):877-882. doi: 10.19723/j.issn.1671-167X.2021.05.011.
To evaluate the relationship between postoperative knee function and the sagittal position of tibial component in unicompartmental knee arthroplasty (UKA).
We retrospectively enrolled the patients who underwent UKA from January 2016 to May 2020. They were assigned into 2 groups according to postoperative posterior tibial slope (PTS): the normal PTS group (PTS≥3° and PTS < 8°) and the abnormal PTS group (PTS < 3° or ≥8°). The patients were followed up for at least 12 months. The postoperative Knee Society Clinical Score (KSS-C), Knee Society Functional Score (KSS-F) and knee range of motion (ROM) were compared between the two groups.
A total of 72 patients (82 knees) were included with 51 patients (58 knees) in PTS normal group and 21 patients (24 knees) in PTS abnormal group. All the patients were followed up with median of 23.6 months. There was no significant difference in the general data [gender, age, body mass index (BMI)], pre-operative knee range of motion, preoperative KSS-C score and KSS-F score ( > 0.01). The KSS-C score, KSS-F score, and knee range of motion significantly improved after surgery ( < 0.01) for all the patients. The postoperative KSS-C score in normal PTS group (88.76±2.79) was significantly higher than the KSS-C score in abnormal PTS group (84.42±3.35, < 0.01), but no significant difference between the 2 groups was observed in postoperative KSS-F score and knee range of motion ( > 0.01). In addition, there was no correlation between the change of PTS and postoperative KSS-C score (=-0.034, 95%: -0.247 to 0.186, = 0.759), KSS-F score ( = -0.014, 95%: -0.238 to 0.198, = 0.901) and knee range of motion (= 0.045, 95%: -0.214 to 0.302, = 0.686).
The posterior tibial slope between 3° and < 8° can be recommended to improve knee joint function in mobile UKA, and excessive or insufficient PTS should be avoided.
评估单髁膝关节置换术(UKA)中术后膝关节功能与胫骨假体矢状位的关系。
我们回顾性纳入了2016年1月至2020年5月接受UKA的患者。根据术后胫骨后倾角度(PTS)将他们分为2组:正常PTS组(PTS≥3°且PTS<8°)和异常PTS组(PTS<3°或≥8°)。对患者进行至少12个月的随访。比较两组术后的膝关节协会临床评分(KSS-C)、膝关节协会功能评分(KSS-F)和膝关节活动范围(ROM)。
共纳入72例患者(82膝),其中PTS正常组51例患者(58膝),PTS异常组21例患者(24膝)。所有患者均获随访,中位随访时间为23.6个月。两组患者的一般资料[性别、年龄、体重指数(BMI)]、术前膝关节活动范围、术前KSS-C评分和KSS-F评分比较,差异均无统计学意义(>0.01)。所有患者术后KSS-C评分、KSS-F评分和膝关节活动范围均显著改善(<0.01)。正常PTS组术后KSS-C评分(88.76±2.79)显著高于异常PTS组(84.42±3.35,<0.01),但两组术后KSS-F评分和膝关节活动范围比较,差异无统计学意义(>0.01)。此外,PTS的变化与术后KSS-C评分(=-0.034,95%可信区间:-0.247至0.186,=0.759)、KSS-F评分(=-0.014,95%可信区间:-0.238至0.198,=0.901)及膝关节活动范围(=0.045,95%可信区间:-0.214至0.302,=0.686)均无相关性。
对于可活动的UKA,建议胫骨后倾角度在3°至<8°之间以改善膝关节功能,应避免PTS过大或过小。