Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Headington, Oxford, OX3 7LD, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK.
J Orthop Surg Res. 2022 Mar 5;17(1):146. doi: 10.1186/s13018-021-02896-3.
Isolated lateral compartment knee arthritis is less prevalent than medial. While the reported results of medial unicompartmental knee replacement (UKR) have been good and comparable to total knee replacement, the results of lateral UKR have been mixed. We present the short-term results and survivorship of a fixed-bearing UKR designed specifically for the lateral compartment.
We report the result of 130 primary fixed-bearing lateral Oxford (FLO) UKRs (123 patients) performed between 2015 and 2019 with a minimum follow-up of 1 year. The indications for lateral UKR were: isolated lateral osteoarthritis (n = 122), post-trauma (n = 5) and osteonecrosis (n = 3). The mean age was 69.1 (± 11.6), mean BMI 28.4 (± 4.9), 66.9% female, 60% right-sided, and mean follow-up 3 (range 1-4.8 years, standard deviation ± 1) years. The primary outcome measure was the Oxford knee score (OKS). Survival analysis was performed with "revision for any reason", "reoperation", and "implant failure" as the endpoints.
Six patients died from unrelated reasons. None of the implants failed. One required the addition of a medial UKR for medial arthritis. There were no other reoperations. At 4 years, the survival for implant failure was 100% and for both revision and all reoperations was 99.5% (95% CI 96.7-99.9%). At the last review, at a mean of 3 years, the mean Oxford knee score was 41.
The good survivorship and outcome scores suggest that UKR designed for the lateral compartment is an excellent alternative to total knee replacement in selected patients with isolated lateral tibiofemoral arthritis at short-term follow-up.
孤立的外侧间室膝关节炎比内侧间室膝关节炎少见。虽然内侧单髁膝关节置换术（UKR）的报告结果良好且可与全膝关节置换术相媲美，但外侧 UKR 的结果却参差不齐。我们介绍了一种专门为外侧间室设计的固定轴承 UKR 的短期结果和生存率。
我们报告了 2015 年至 2019 年间进行的 130 例原发性固定轴承外侧牛津（FLO）UKR（123 例患者）的结果，随访时间至少为 1 年。外侧 UKR 的适应证为：孤立的外侧骨关节炎（n=122）、创伤后（n=5）和骨坏死（n=3）。平均年龄为 69.1（±11.6）岁，平均 BMI 为 28.4（±4.9），66.9%为女性，60%为右侧，平均随访时间为 3 年（范围 1-4.8 年，标准差±1）。主要观察指标为牛津膝关节评分（OKS）。生存分析以“任何原因的翻修”、“再次手术”和“假体失败”为终点。
有 6 例患者因非相关原因死亡。无假体失败。有 1 例需要加行内侧 UKR 治疗内侧关节炎。无其他再次手术。4 年时，假体失败的生存率为 100%，翻修和所有再次手术的生存率为 99.5%（95%CI 96.7-99.9%）。末次随访时，平均 3 年，平均牛津膝关节评分为 41 分。
良好的生存率和结果评分表明，在选择的孤立性外侧胫骨股骨关节炎患者中，外侧间室设计的 UKR 在短期随访中是全膝关节置换术的一种极好的替代方法。
