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15 年随访:活动平台型单髁膝关节置换术。

15-Year Follow-Up of Mobile Bearing Medial Unicompartmental Knee Arthroplasty.

机构信息

JIS Orthopedics, New Albany, Ohio.

出版信息

J Arthroplasty. 2023 Jul;38(7):1257-1261. doi: 10.1016/j.arth.2023.01.024. Epub 2023 Jan 26.

Abstract

INTRODUCTION

Medial unicompartmental knee arthroplasty (UKA) is a successful treatment for antero-medial osteoarthritis. However, there are few published studies on the long-term survival of this procedure. The purpose of this study was to review the 15-year minimum outcomes and survival of a mobile-bearing medial UKA.

METHODS

A retrospective review was performed between July 2004 and December 2006 of all patients who underwent a medial UKA eligible for a minimum of 15-year follow-up. The initial query revealed 299 patients (349 knees). One hundred-seventeen patients died or were lost to follow-up, leaving 182 patients (219 knees) for analyses. Clinical outcomes and survivorship were analyzed.

RESULTS

There were 59 implant-related reoperations which occurred at a mean of 10 years (range, 0 to 16 years). The most common reasons for reoperation were arthritic progression (9.1%) and aseptic loosening (9.1%). The 10-year survival with revision to TKA was 89% (95% confidence interval: 86% to 92.4%), and the 15-year survival was 84.1% (95% confidence interval: 80.3% to 88%). There were no statistically significant differences in survival between sex, body mass index, and age. Patients who were not revised had statistically significant improvements in knee range of motion and Knee Society scores.

CONCLUSIONS

This study found similar long-term survival of a medial mobile-bearing UKA to published total knee arthroplasty outcomes. The implant evaluated in this study has undergone subsequent improvements in instrumentation and design. Further analyses should be performed on the long-term outcomes of the current implant platform.

摘要

引言

单髁膝关节置换术(UKA)是治疗前内侧骨关节炎的一种成功方法。然而,关于该手术的长期生存率,发表的研究较少。本研究的目的是回顾一种活动衬垫内侧 UKA 的 15 年最低随访结果和生存率。

方法

对 2004 年 7 月至 2006 年 12 月期间所有符合至少 15 年随访条件的内侧 UKA 患者进行回顾性研究。最初的查询显示有 299 例患者(349 膝)。171 例患者死亡或失访,182 例患者(219 膝)可进行分析。分析了临床结果和生存率。

结果

共有 59 例与植入物相关的再手术,平均发生在 10 年(范围,0 至 16 年)。再手术最常见的原因是关节炎进展(9.1%)和无菌性松动(9.1%)。翻修为全膝关节置换术的 10 年生存率为 89%(95%置信区间:86%至 92.4%),15 年生存率为 84.1%(95%置信区间:80.3%至 88%)。性别、体重指数和年龄对生存率无统计学差异。未进行翻修的患者膝关节活动度和膝关节协会评分有显著改善。

结论

本研究发现,内侧活动衬垫 UKA 的长期生存率与已发表的全膝关节置换术结果相似。本研究评估的植入物在器械和设计方面都进行了后续改进。应进一步分析当前植入物平台的长期结果。

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