IULS, CHU Nice, Nice, France.
Sport Clinique of, Bordeaux-Mérignac, France.
Knee Surg Sports Traumatol Arthrosc. 2023 Sep;31(9):3919-3926. doi: 10.1007/s00167-023-07388-x. Epub 2023 Apr 1.
The purpose of this study was to analyze the clinical outcomes and radiologic position of the knee in two groups of patients after medial unicompartmental knee arthroplasty (UKA): one group with residual varus axis (RVA) alignment and other one with neutral mechanical axis (NMA) of the lower limb.
All patients who underwent UKA between January 2015 and January 2018 were evaluated retrospectively. Inclusion criteria were: medial UKA for isolated medial femoro-tibial osteoarthritis, a varus deformity of < 15°, and a minimal follow-up of 2 years. All patients had a preoperative and postoperative clinical examination with functional scores (New International Knee Score (NewIKS) and Knee injury and Osteoarthritis Outcome Score (KOOS) and radiographs. Preoperative and postoperative values for continuous outcomes were compared using the Student's t test for paired data and differences between the groups were compared with the Mann-Whitney U test. p < 0.05 was considered statistically significant.
The RVA group consisted of 48 cases of medial UKA in 48 patients (22 females). Mean postoperative hip-knee-ankle (HKA) angle was 174.3° ± 2.8 and the corresponding mean AKI angle (tibial mechanical angle) was 82.9° ± 2.9. The NMA group consisted of 35 cases of medial UKA in 35 patients (14 females). Mean postoperative HKA angle was 178.9° ± 3 and the corresponding mean AKI angle was 85.5° ± 3.1. A significant difference was found between the two groups for the KOOS score and for global NewIKS, with a better score in the RVA group.
RVA alignment after medial UKA results in a significant improvement in functional knee scores at 2-year post-surgery. Return to sport and recreational activities was better than in patients with postoperative NMA.
Level 3; retrospective cohort study.
本研究旨在分析内侧单髁膝关节置换术后两组患者的临床结果和膝关节影像学位置：一组存在残余内翻轴（RVA），另一组下肢机械轴为中立位（NMA）。
回顾性分析 2015 年 1 月至 2018 年 1 月期间接受 UKA 的所有患者。纳入标准为：单纯内侧股胫关节骨关节炎的内侧 UKA、<15°的内翻畸形和至少 2 年的随访。所有患者均行术前和术后临床检查，包括功能评分（新国际膝关节评分（NewIKS）和膝关节损伤和骨关节炎结果评分（KOOS）和影像学检查。采用配对学生 t 检验比较连续结果的术前和术后值，采用 Mann-Whitney U 检验比较两组间的差异。p<0.05 为统计学显著差异。
RVA 组包括 48 例 48 例（22 例女性）患者的内侧 UKA。术后平均髋膝踝角（HKA）为 174.3°±2.8，相应的平均 AKI 角（胫骨机械角）为 82.9°±2.9。NMA 组包括 35 例 35 例（14 例女性）患者的内侧 UKA。术后平均 HKA 角为 178.9°±3，相应的平均 AKI 角为 85.5°±3.1。两组间 KOOS 评分和总体 NewIKS 评分存在显著差异，RVA 组评分更好。
内侧 UKA 后 RVA 对线可显著改善术后 2 年膝关节功能评分。术后 RVA 组患者重返运动和娱乐活动的情况优于 NMA 组。
3 级；回顾性队列研究。
