基于 92 例患者队列的内侧单髁膝关节置换术后重返撞击运动的回顾性分析。

Retrospective analysis of return to impact sport after medial unicompartmental knee arthroplasty based on a cohort of 92 patients.

机构信息

Institute for Locomotion, Center for Arthritis Surgery, Sainte-Marguerite Hospital, Marseille, France.

出版信息

Orthop Traumatol Surg Res. 2023 Jun;109(4):103577. doi: 10.1016/j.otsr.2023.103577. Epub 2023 Feb 6.

DOI:10.1016/j.otsr.2023.103577

PMID:36754168

Abstract

BACKGROUND

Return to sport after Knee Arthroplasty has been investigated reporting modifications in the physical activities with a trend towards to lower impact sports after Unicompartemental Knee Arthroplasty. The purpose of this study was to analyze the return to sport level after medial unicompartmental knee arthroplasty (MUKA) in a population of osteoarthritic patients having practiced impact sport, defined with a University of California at Los Angeles activity scale (UCLA)≥9 in their pre-symptomatic arthritic period.

HYPOTHESIS

Return to an impact sport after MUKA was possible for a population of osteoarthritic patients having practiced impact sport in their pre-symptomatic arthritic period.

METHODS

Ninety-two MUKA with a pre-symptomatic arthritic UCLA score≥9, including 60 men (65.2%) and operated between January 2009 and September 2014, were evaluated by a dedicated survey. Informations were obtained concerning the physical activities (intensity, frequency, kind of sport, reasons to decrease or stop the physical activities in the pre- and the postoperative period). The average age was 64.9 years±6.4 (range 49-74.4). Three different periods were compared: pre-symptomatic arthritic, preoperative and postoperative period. The mean follow-up was 7.3±1.7 years.

RESULTS

The mean pre-symptomatic arthritic UCLA score was 9.9±0.3, the mean preoperative UCLA score was 7.0±2.5 (2-10) and the mean postoperative UCLA score was 7.2±2.0 (3-10). There were significant differences for the mean UCLA score values between pre-symptomatic arthritis and postoperative UCLA scores (p=0.034), however no difference was detected in mean score values before and after surgery (p=0.09). Only 32.6% (30/92) of patients had a postoperative UCLA score≥9. For patients practicing an impact sport activity (UCLA≥9) in the preoperative period (23/92; 25%), the postoperative UCLA score was at 8±1.1 (range 4-10). In this subgroup, 47.8% (11/23) of patients had a postoperative UCLA score≥9. The decline in sports in postoperative was predominantly explained by residual pain of the operated knee (31/92; 34%), precaution to not damage the prosthesis (25/92; 27%) and restrictions due to another joint (19/92; 21%).

DISCUSSION

Return to impact sport after MUKA seems to be limited to a restrained number of patients. The main reasons to the decline in sporting activity level are linked to the residual pain of the operated knee and the precaution to not damage the prosthesis.

LEVEL OF EVIDENCE

IV, retrospective cohort study.

摘要

背景

膝关节置换术后重返运动已得到广泛研究，研究表明单髁膝关节置换术后患者的体育活动发生了改变，倾向于从事低影响运动。本研究的目的是分析患有影响性运动的骨关节炎患者在接受单髁膝关节置换术后（MUKA）的运动水平恢复情况，这些患者在亚临床关节炎期的加利福尼亚大学洛杉矶分校（UCLA）活动量表评分≥9。

假设

对于在亚临床关节炎期进行过影响性运动的骨关节炎患者，MUKA 后重返影响性运动是可能的。

方法

92 例 MUKA 患者，术前亚临床关节炎 UCLA 评分≥9，包括 60 名男性（65.2%），手术时间为 2009 年 1 月至 2014 年 9 月，通过专门的问卷调查进行评估。获得的信息包括体育活动（强度、频率、运动类型、术前和术后减少或停止体育活动的原因）。平均年龄为 64.9±6.4 岁（范围 49-74.4 岁）。比较了三个不同的时期：亚临床关节炎期、术前和术后。平均随访时间为 7.3±1.7 年。

结果

术前亚临床关节炎期 UCLA 平均评分为 9.9±0.3，术前 UCLA 平均评分为 7.0±2.5（2-10），术后 UCLA 平均评分为 7.2±2.0（3-10）。术前亚临床关节炎期和术后 UCLA 评分的平均 UCLA 评分值存在显著差异（p=0.034），但术前和术后的平均评分值无差异（p=0.09）。仅有 32.6%（30/92）的患者术后 UCLA 评分≥9。在术前（23/92；25%）接受影响性运动（UCLA≥9）的患者中，术后 UCLA 评分为 8±1.1（范围 4-10）。在这个亚组中，47.8%（11/23）的患者术后 UCLA 评分≥9。术后运动减少主要归因于膝关节术后残留疼痛（31/92；34%）、防止假体损坏（25/92；27%）和其他关节受限（19/92；21%）。