Panzram Benjamin, Barbian Frederik, Reiner Tobias, Hariri Mustafa, Renkawitz Tobias, Walker Tilman
Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
J Clin Med. 2023 Feb 20;12(4):1694. doi: 10.3390/jcm12041694.
The number of unicompartmental knee replacements (UKR) is increasing. Alongside various advantages, the revision rate of cemented UKR is higher compared to total knee arthroplasty (TKR). In contrast, cementless fixation shows reduced revision rates, compared to the cemented UKR. However, most of the recent literature is based on designer-dependent studies. In this retrospective, single-center cohort study, we investigated patients who underwent cementless Oxford UKR (OUKR) between 2012 and 2016 in our hospital with a minimum follow-up of five years. Clinical outcome was evaluated using the OKS, AKSS-O, AKSS-F, FFbH-OA, UCLA, SF-36, EQ-5D-3L, FJS, ROM, pain, and satisfaction measures. Survival analysis was performed with reoperation and revision as endpoints. We included 201 patients (216 knees) for clinical evaluation. All outcome parameters increased significantly from pre- to postoperative stages. The five-year survival rate was 96.1% for revision surgery and 94.9% for reoperation. The main reasons for revision were the progression of osteoarthritis, inlay dislocation, and tibial overstuffing. Two iatrogenic tibial fractures appeared. Cementless OUKR shows excellent clinical outcome and high survival rates after five years. The tibial plateau fracture in cementless UKR represents a serious complication and requires modification of the surgical technique.
单髁膝关节置换术（UKR）的数量正在增加。除了各种优点外，骨水泥固定的UKR翻修率高于全膝关节置换术（TKR）。相比之下，非骨水泥固定与骨水泥固定的UKR相比，翻修率较低。然而，最近的大多数文献都是基于依赖设计者的研究。在这项回顾性单中心队列研究中，我们调查了2012年至2016年在我院接受非骨水泥牛津单髁膝关节置换术（OUKR）且至少随访五年的患者。使用OKS、AKSS-O、AKSS-F、FFbH-OA、UCLA、SF-36、EQ-5D-3L、FJS、ROM、疼痛和满意度指标评估临床结果。以再次手术和翻修为终点进行生存分析。我们纳入了201例患者（216膝）进行临床评估。所有结果参数从术前到术后阶段均显著增加。翻修手术的五年生存率为96.1%，再次手术的五年生存率为94.9%。翻修的主要原因是骨关节炎进展、嵌体脱位和胫骨填充过多。出现了两例医源性胫骨骨折。非骨水泥OUKR显示出良好的临床结果和五年后的高生存率。非骨水泥UKR中的胫骨平台骨折是一种严重的并发症，需要改进手术技术。
