Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Arch Orthop Trauma Surg. 2023 Sep;143(9):5849-5856. doi: 10.1007/s00402-023-04841-x. Epub 2023 Mar 14.
The aim of the current study was to demonstrate short- to mid-term survivorship as well as clinical outcome of lateral unicompartmental knee replacement (UKR) with a fixed-bearing (FB) design from a non-designer center using the Oxford Fixed Lateral prosthesis.
This single-center retrospective cohort study reports the results of 133 consecutive lateral FB-UKR. Survivorship analysis was performed with different endpoints and clinical outcome was measured using the Oxford-Knee-Score (OKS), American-Knee-Society-Score (AKSS-O), range-of-motion (ROM) and visual-analog-scale for pain (VAS).
There were two revision surgeries with conversion to total knee replacements (TKR) due to persistent pain resulting in a survival rate of 98.5% (95% CI 93.5-99.6) with a mean follow-up (FU) of 3.3 ± 1.8 years (range 1-8.5). All outcome scores, VAS and ROM showed a significant improvement at final FU (p < 0.001). The OKS improved from 26 ± 7.8 (range 11-45) preoperatively to 39 ± 8.3 (range 13-48), the AKSS-O from 49.2 ± 14.6 (range 18-90) to 81.8 ± 15.1 (range 40-100), the AKSS-F from 53 ± 23.7 (range 0-100) to 80.4 ± 21.4 (range 5-100) and the ROM from 118 ± 17 (range 90-160) to 134 ± 9.5 (range 100-155).
The short- to mid-term results following lateral FB-UKR demonstrate a high survivorship and good clinical outcome from an independent series. We, therefore, suggest that FB-UKR is a safe treatment option for isolated lateral OA if sufficient surgical experience is provided.
Retrospective cohort study, level IV.
本研究旨在展示在非设计中心使用牛津固定侧假体的固定（FB）设计的外侧单髁膝关节置换（UKR）的短期至中期存活率和临床结果。
这是一项单中心回顾性队列研究，报告了 133 例连续外侧 FB-UKR 的结果。使用不同的终点进行生存分析，使用牛津膝关节评分（OKS）、美国膝关节协会评分（AKSS-O）、活动范围（ROM）和疼痛视觉模拟评分（VAS）测量临床结果。
有两例因持续性疼痛而转为全膝关节置换（TKR）的翻修手术，因此生存率为 98.5%（95%CI 93.5-99.6），平均随访（FU）时间为 3.3±1.8 年（范围 1-8.5 年）。所有的结果评分、VAS 和 ROM 在最终 FU 时均有显著改善（p<0.001）。OKS 从术前的 26±7.8（范围 11-45）改善到 39±8.3（范围 13-48），AKSS-O 从 49.2±14.6（范围 18-90）改善到 81.8±15.1（范围 40-100），AKSS-F 从 53±23.7（范围 0-100）改善到 80.4±21.4（范围 5-100），ROM 从 118±17（范围 90-160）改善到 134±9.5（范围 100-155）。
外侧 FB-UKR 的短期至中期结果显示出较高的存活率和良好的临床结果，这是一项独立系列研究。因此，如果提供足够的手术经验，我们认为 FB-UKR 是治疗孤立性外侧 OA 的一种安全治疗选择。
回顾性队列研究，IV 级。
