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关节置换术后外翻对线并不影响单髁膝关节置换术后短期患者报告的结局测量。

Perioperative varus alignment does not affect short-term patient-reported outcome measures following mobile-bearing unicompartmental knee arthroplasty.

机构信息

Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

出版信息

J Orthop Surg Res. 2022 Feb 15;17(1):98. doi: 10.1186/s13018-022-02999-5.

Abstract

BACKGROUND

Although favorable long-term survival of Oxford unicompartmental knee arthroplasty (UKA) has been reported regardless of postoperative varus alignment, the effect of degree of varus alignment on patient-reported outcome measures (PROMs) remains unclear. Furthermore, the Forgotten Joint Score-12 (FJS-12), which has a low ceiling effect, may be useful for such assessment. The objective of this study was to evaluate short-term clinical outcomes after Oxford UKA in knees with a greater degree of preoperative varus alignment focusing on use of the FJS-12.

METHODS

This retrospective study involved 66 knees that had undergone primary Oxford UKA. Based on the hip-knee-ankle angle, the knees were divided into two alignment groups: severe varus group (≥ 185° varus alignment) and a mild varus group (< 185° varus alignment). PROMs, including the FJS-12, Knee Injury and Osteoarthritis Outcome Score, and Knee Society Score, were obtained pre- and postoperatively for assessment of clinical outcomes. In addition, the ceiling effect of the FJS-12 was evaluated.

RESULTS

All PROMs showed significant improvement after surgery. However, there were no statistically significant differences between the severe varus group and the mild varus group. Moreover, no ceiling effect was found for the FJS-12 in this study.

CONCLUSION

Short-term results were good for Oxford UKA in knees with a greater degree of varus alignment and were not significantly different from those in knees with mild varus alignment.

摘要

背景

尽管牛津单髁膝关节置换术(UKA)术后无论发生内翻还是外翻对线,均有良好的长期生存率,但术后对线对内翻角度的影响对患者报告的结果测量(PROM)的影响尚不清楚。此外,内翻角度较大的膝关节行牛津 UKA 术后,可能需要使用内翻角度较小的膝关节,而遗忘关节评分 12 分(FJS-12)的天花板效应较低,可能对此类评估有用。本研究的目的是评估术前内翻角度较大的膝关节行牛津 UKA 术后的短期临床结果,并重点评估 FJS-12 的使用情况。

方法

这是一项回顾性研究,纳入了 66 例接受初次牛津 UKA 的膝关节。根据髋膝踝角(HKA),膝关节被分为两组:严重内翻组(≥185°内翻对线)和轻度内翻组(<185°内翻对线)。使用 FJS-12、膝关节损伤和骨关节炎结果评分(KOOS)和膝关节协会评分(KSS)等 PROM 进行术前和术后评估,以评估临床结果。此外,还评估了 FJS-12 的天花板效应。

结果

所有 PROM 在术后均有显著改善。然而,严重内翻组与轻度内翻组之间无统计学差异。此外,本研究中 FJS-12 未发现天花板效应。

结论

对于内翻角度较大的膝关节,牛津 UKA 的短期结果良好,与轻度内翻角度的膝关节无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edc7/8848965/6a5121688bea/13018_2022_2999_Fig1_HTML.jpg

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