Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
Orthopaedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):986-997. doi: 10.1007/s00167-022-07132-x. Epub 2022 Sep 5.
Unicompartmental knee arthroplasty (UKA) is an effective treatment for late knee osteoarthritis (OA). Young age (< 60 years) has been associated with worse outcomes. The goal of this systematic review and meta-analysis is to study the effect of age on UKA outcomes.
The primary objective was to compare the UKA revision rate in young patients with that of old patients, using the age thresholds of 60 and 55 years. Secondary objectives were patient-reported outcome measures (PROMs) and implant design. Five databases were searched in December 2021 for original comparative studies with a minimum of 1-year follow-up. No restrictions were placed on the type of UKA prosthesis.
A total of 11 observational studies with 6130 knees were included. A mean MINORS score of 19 was assigned to the review. The mean age of patients was 64 years, with average follow-up of 7.5 ± 2.98 years. There was no significant difference in revision rate, incident or PROMs between young and old patients in the analysis for each age threshold. Further sub-analysis adjusting for implant type in mobile- and fixed-bearing prostheses also showed similar results between those above and under 60 and 55 years.
Young age was not associated with a higher revision rate or lower functional scores. Thus, this review provides evidence that age alone is not a contraindication to UKA, but the surgical choice must be based on several elements, and this finding should be applied in context, given the binary division and heterogeneity of patients.
III.
单髁膝关节置换术（UKA）是治疗晚期膝关节骨关节炎（OA）的有效方法。年龄较轻（<60 岁）与较差的结果相关。本系统评价和荟萃分析的目的是研究年龄对 UKA 结果的影响。
主要目的是比较年轻患者和老年患者的 UKA 翻修率，使用 60 岁和 55 岁的年龄阈值。次要目标是患者报告的结果测量（PROMs）和植入物设计。2021 年 12 月，对具有至少 1 年随访的原始对照研究进行了五项数据库检索。对 UKA 假体的类型没有限制。
共纳入 11 项观察性研究，涉及 6130 例膝关节。对该综述的平均 MINORS 评分为 19 分。患者的平均年龄为 64 岁，平均随访时间为 7.5±2.98 年。在每个年龄阈值的分析中，年轻患者和老年患者之间在翻修率、发生率或 PROMs 方面没有显著差异。进一步调整活动和固定轴承假体的植入物类型的亚分析也显示了 60 岁和 55 岁以上和以下患者之间的相似结果。
年龄较轻与翻修率较高或功能评分较低无关。因此，本综述提供的证据表明，年龄本身并不是 UKA 的禁忌症，但手术选择必须基于多个因素，并且鉴于患者的二分法和异质性，应在具体情况下应用这一发现。
III。
