Gelenkpunkt-Sports and Joint Surgery, FIFA Medical Centre of Excellence, Olympiastraße 39, 6020, Innsbruck, Austria.
Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), Private University for Health Sciences, Medical Informatics and Technology, Innsbruck, Austria.
Knee Surg Sports Traumatol Arthrosc. 2023 Aug;31(8):3098-3105. doi: 10.1007/s00167-022-07166-1. Epub 2022 Sep 26.
The purpose of this study was to compare (1) sports participation and type of sports activity between TKA and UKA patients; (2) functional outcome and activity level between TKA and UKA; and (3) survivorship of the prosthesis in both the groups.
Prospectively collected data were obtained from an arthroplasty database to identify patients who underwent primary TKA and UKA. Both the cohorts of TKA and UKA were matched, controlling for age, sex, BMI and preoperative patient-reported outcomes, which include Oxford Knee Score (OKS), Tegner activity level, and visual analog scale (VAS) for pain score. After matching the two groups, 287 TKA and 69 UKA cases were available to be included in the study. Patients were evaluated pre- and postoperatively at 2 years for sports participation and sports preference, patient-reported outcomes, activity levels, and improvement in knee pain.
The mean age of the TKA and UKA groups were 75.7 ± 8.1 and 74.2 ± 8.8, respectively. There was no significant difference between the two groups concerning the demographic variables. Significant improvement was noted in the weekly sports participation at the final follow-up compared to preoperative sports participation in both the TKA and UKA groups (p < 0.05). All patients were able to return to their desired sporting activity. No significant difference was noted between the two groups in sports participation preoperatively and postoperatively (p > 0.05). OKS, Tegner activity level and VAS for pain demonstrated a significant improvement from preoperative to 2 years postoperatively (p < 0.05). However, preoperative and postoperative patient-reported outcomes did not differ significantly between the TKA and UKA groups (p > 0.05). No case of revision surgery was found at a 2-year follow-up in both groups.
Traditionally, in isolated medial compartment osteoarthritis, UKA has been considered to be the procedure with better functional outcomes, but the current study demonstrates that when confounding factors are controlled, both TKA and UKA are effective, and offer similar functional outcomes and result in similar improvement in sports participation. These findings will be helpful to counsel the patients to choose the best suitable operative procedure between UKA and TKA.
Level 3.
本研究旨在比较（1）TKA 和 UKA 患者的运动参与度和运动类型；（2）TKA 和 UKA 的功能结果和活动水平；以及（3）两组假体的存活率。
从关节置换数据库中前瞻性收集数据，以确定接受初次 TKA 和 UKA 的患者。通过控制年龄、性别、BMI 和术前患者报告的结果（包括牛津膝关节评分（OKS）、Tegner 活动水平和疼痛视觉模拟评分（VAS）），对 TKA 和 UKA 两组患者进行匹配。在对两组进行匹配后，共有 287 例 TKA 和 69 例 UKA 病例纳入研究。患者在术后 2 年时进行随访，评估运动参与度和运动偏好、患者报告的结果、活动水平以及膝关节疼痛的改善情况。
TKA 和 UKA 组的平均年龄分别为 75.7±8.1 岁和 74.2±8.8 岁。两组在人口统计学变量方面无显著差异。与术前相比，两组在最终随访时的每周运动参与度均有显著提高（p<0.05）。所有患者均能恢复到期望的运动活动水平。两组在术前和术后的运动参与度方面无显著差异（p>0.05）。OKS、Tegner 活动水平和 VAS 疼痛评分均显示从术前到术后 2 年有显著改善（p<0.05）。然而，TKA 和 UKA 两组之间的术前和术后患者报告结果无显著差异（p>0.05）。两组在 2 年随访时均未发现翻修手术。
传统上，在单纯内侧间室骨关节炎中，UKA 被认为是功能结果更好的手术方法，但本研究表明，当控制混杂因素时，TKA 和 UKA 同样有效，提供相似的功能结果，并导致运动参与度的相似改善。这些发现将有助于为患者提供有关在 UKA 和 TKA 之间选择最佳手术方法的建议。
3 级。
