Xu Zhi-Qing, Zhuang Zhi-Kun, Gong Zhi-Bing, Wu Rong-Kai, Xu Fu-Dong
Department of Joint Surgery, Quanzhou Orthopedics Hospital, Quanzhou 362000, Fujian, China.
Zhongguo Gu Shang. 2023 Jun 25;36(6):507-13. doi: 10.12200/j.issn.1003-0034.2023.06.003.
To evaluate outcomes of mixed unicompartmental knee arthroplasty(UKA) and total knee arthroplasty(TKA) in the treatment of medial osteoarthritis(OA) of the knee.
Retrospective analysis of 156 patients, 44 males and 112 females, aged from 50 to 75 years old with an average of(58.76±4.97) years old, who underwent knee arthroplasty from October 2017 to October 2019. The patients were divided into two groups:81 cases(81 knees) underwent TKA, including 23 males and 58 females, aged from 51 to 75 years old with an average of (58.60±5.01) years old, and 75 case (75 knees) underwent UKA with mixed phase 3 Oxford, including 21 males and 54 females, aged from 50 to 72 years old with an average of (58.92±4.95) years old. The two groups were compared regarding to the clinical outcomes, assessed using surgical information and complications, American Knee Society score(AKSS) clinical score and functional score. Radiographs were assessed using hip-knee-ankle angle(HKA), tibial component valgus/varus angle(TCVA), tibial component posterior slope angle(TCPSA), femoral component valgus/varus angle(FCVA), femoral component posterior slope angle(FCPSA), looking for bearing dislocation, prosthesis loosening, progression of OA in lateral compartment.
Intraoperative bleeding, operative time and hospital days were significantly better in the UKA group than in the TKA group (<0.05), and there were no postoperative complications in either group. Patients in both groups were enrolled with an average follow-up time of (38.01±8.90) months, ranged from 24 to 54 months. AKSS functional, AKSS clinical, HKA in both groups significantly improved at the final follow-up compared with those before operation. At the final follow-up, the UKA group was significantly better than the TKA group in AKSS functional and AKSS clinical, whereas HKA in the TKA group was better. At the final follow-up. TCVA and FCVA between the two groups were not significantly different, while TCPSA and FCPSA in the UKA group were significantly greater than the TKA group. No signs of progression of OA to the lateral compartment were observed.
Mixed phase 3 Oxford UKA in medial unicompartmental knee osteoarthritis was considerably better than TKA for less blood loss, shorter operation time, shorter hospital stay, rapid postoperative recovery, helping achieve satisfactory function, provided satisfactory outcome.
评估混合式单髁膝关节置换术（UKA）和全膝关节置换术（TKA）治疗膝关节内侧骨关节炎（OA）的疗效。
回顾性分析2017年10月至2019年10月行膝关节置换术的156例患者，其中男性44例，女性112例，年龄50至75岁，平均（58.76±4.97）岁。患者分为两组：81例（81膝）行TKA，其中男性23例，女性58例，年龄51至75岁，平均（58.60±5.01）岁；75例（75膝）行3期混合牛津单髁膝关节置换术，其中男性21例，女性54例，年龄50至72岁，平均（58.92±4.95）岁。比较两组的临床疗效，通过手术信息、并发症、美国膝关节协会评分（AKSS）临床评分和功能评分进行评估。通过髋-膝-踝角（HKA）、胫骨假体外翻/内翻角（TCVA）、胫骨假体后倾角度（TCPSA）、股骨假体外翻/内翻角（FCVA）、股骨假体后倾角度（FCPSA）评估X线片，观察有无轴承脱位、假体松动、外侧间室OA进展情况。
UKA组术中出血量、手术时间和住院天数均显著优于TKA组（<0.05），两组均无术后并发症。两组患者平均随访时间为（38.01±8.90）个月，范围为24至54个月。末次随访时，两组的AKSS功能评分、AKSS临床评分、HKA均较术前显著改善。末次随访时，UKA组的AKSS功能评分和AKSS临床评分显著优于TKA组，而TKA组的HKA更好。末次随访时，两组间的TCVA和FCVA无显著差异，而UKA组的TCPSA和FCPSA显著大于TKA组。未观察到OA向外侧间室进展的迹象。
对于内侧单髁膝关节骨关节炎，3期混合牛津UKA在减少失血、缩短手术时间、缩短住院时间、术后恢复快、帮助实现满意功能方面明显优于TKA，疗效满意。
