Seattle, Washington.
J Arthroplasty. 2022 Oct;37(10):2004-2008. doi: 10.1016/j.arth.2022.04.044. Epub 2022 May 4.
Five percent to 7% of unicompartmental knee arthroplasties (UKA) require revision for disease progression in untreated compartment(s), most commonly to total knee arthroplasty (TKA). TKA requires removal of bone and usually the anterior cruciate ligament. Preserving the UKA and converting to a bicompartmental arthroplasty (BCA) by performing a second UKA is an alternative.
The results of 73 UKA-BCA patients were compared to 75 patients treated by UKA-TKA revision. Knee Society, Knee Osteoarthritis Outcome Score Joint Replacement, and patient satisfaction scores were collected by a blinded therapist. Patients were asked about their implant preference and recovery. Twenty-two UKA-BCA revision patients had a UKA (6) or TKA (16) in the contralateral knee; thus, a direct comparison of UKA-BCA to both UKA and TKA was possible.
Of the UKA-BCA patients, 69 (94%) had excellent or good, 2 (3%) fair, and 2 (3%) poor outcomes with 1 patient requiring revision to TKA. Of patients with a TKA in the contralateral knee, 13 (81%) preferred the UKA-BCA replacement and 3 (19%) preferred the TKA. All patients said the UKA-BCA revision recovery was similar or easier than their initial UKA. Of UKA-TKA revisions, 59 (79%) had excellent or good, 9 (12%) fair, and 7 (9%) poor outcomes. There was 1 wound infection and 1 re-revision in the UKA-BCA group and 1 wound infection and 3 re-revisions in the UKA-TKA group. The Knee Osteoarthritis Outcome Score Joint Replacement and Knee Society Scores were better for UKA-BCA compared to UKA-TKA.
UKA-BCA is a successful treatment for disease progression following UKA.
5%至 7%的单间膝关节置换术（UKA）需要对未治疗间室（通常为全膝关节置换术（TKA））的疾病进展进行翻修。TKA 需要去除骨，通常还需要前交叉韧带。通过进行第二次 UKA 来保留 UKA 并转换为双间室关节置换术（BCA）是另一种选择。
将 73 例 UKA-BCA 患者的结果与 75 例 UKA-TKA 翻修患者进行比较。由一名经过盲法治疗师收集膝关节协会（Knee Society）、膝关节骨关节炎结局评分（Knee Osteoarthritis Outcome Score Joint Replacement）和患者满意度评分。患者被问到他们对植入物的偏好和康复情况。22 例 UKA-BCA 翻修患者对侧膝关节行 UKA（6 例）或 TKA（16 例）；因此，可以对 UKA-BCA 与 UKA 和 TKA 进行直接比较。
UKA-BCA 患者中，69 例（94%）结果为优或良，2 例（3%）为可，2 例（3%）为差，1 例需要翻修为 TKA。对侧膝关节行 TKA 的患者中，13 例（81%）更喜欢 UKA-BCA 置换，3 例（19%）更喜欢 TKA。所有患者均表示 UKA-BCA 翻修后的恢复情况与初次 UKA 相似或更容易。UKA-TKA 翻修患者中，59 例（79%）结果为优或良，9 例（12%）为可，7 例（9%）为差。UKA-BCA 组有 1 例伤口感染和 1 例再次翻修，UKA-TKA 组有 1 例伤口感染和 3 例再次翻修。与 UKA-TKA 相比，UKA-BCA 的膝关节骨关节炎结局评分（Knee Osteoarthritis Outcome Score Joint Replacement）和膝关节协会评分更好。
UKA-BCA 是 UKA 后疾病进展的成功治疗方法。
