Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Orthopaedic Surgery, West Suffolk Trust Hospital, Suffolk, IP33 2QZ, UK.
Eur J Orthop Surg Traumatol. 2023 May;33(4):811-818. doi: 10.1007/s00590-022-03202-5. Epub 2022 Feb 4.
Several factors influence the outcome of unicompartmental knee replacements. This study investigates the correlation of specific preoperative patient variables with postoperative functional outcomes-measured with the American Knee Society Knee (KS-KS) and Function Scores (KS-FS), as well as the difference in knee flexion pre- and postoperatively.
In a retrospective study of 242 patients who underwent a medial Physica ZUK unicompartmental knee replacement (UKR), the American KS-KS, KS-FS as well as knee flexion were analyzed preoperatively and at 2-year follow-up. The absolute scores and improvement in scores were calculated per subgroup for gender, age, body mass index (BMI) and Kellgren-Lawrence (KL) radiological grade and compared between the subgroups.
All groups had a significant improvement in range of flexion, KS-KS and KS-FS. Female patients had lower preoperative scores and significantly larger improvement in knee flexion and KS-FS. Age does not seem to be associated with the postoperative functional outcome. Patients with a BMI of 30 or higher had a lower postoperative KS-KS and KS-FS as well as knee flexion. Patients with KL grade IV changes had larger gain in KS-KS compared to patients with grade III.
Overall, KS-KS, KS-FS and knee flexion improve significantly 2 years following a Physica ZUK UKR in all groups. Although excellent results were found in patients with a BMI of 30 or higher, a decrease in BMI was associated with an increase in functional outcome. KL IV grade preoperatively was associated with a better KS-KS improvement compared to the KL III group 2 years postoperatively. This information can aid surgeons in patient selection and to counsel patients on outcomes.
III.
有几个因素会影响单髁膝关节置换术的结果。本研究调查了特定术前患者变量与术后功能结果的相关性——使用美国膝关节协会膝关节（KS-KS）和功能评分（KS-FS）进行测量，以及膝关节屈伸度术前和术后的差异。
在对 242 例接受内侧 Physica ZUK 单髁膝关节置换术（UKR）的患者进行回顾性研究中，分析了美国 KS-KS、KS-FS 以及膝关节屈伸度，分别在术前和 2 年随访时进行评估。按照性别、年龄、体重指数（BMI）和 Kellgren-Lawrence（KL）放射学分级对每个亚组进行绝对评分和评分改善的计算，并对各亚组之间进行比较。
所有组的膝关节屈伸度、KS-KS 和 KS-FS 均有显著改善。女性患者术前评分较低，膝关节屈伸度和 KS-FS 的改善幅度明显更大。年龄似乎与术后功能结果无关。BMI 为 30 或更高的患者术后 KS-KS 和 KS-FS 以及膝关节屈伸度较低。KL 分级为 IV 级的患者术后 KS-KS 改善幅度大于 KL 分级为 III 级的患者。
总体而言，在所有组中，Physica ZUK UKR 术后 2 年，KS-KS、KS-FS 和膝关节屈伸度均显著改善。尽管 BMI 为 30 或更高的患者取得了良好的结果，但 BMI 的降低与功能结果的提高相关。术前 KL 分级为 IV 级与术后 2 年 KL 分级为 III 级患者相比，KS-KS 改善更好。这些信息可以帮助外科医生进行患者选择，并向患者提供关于结果的咨询。
III 级。
