Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark.
Arch Orthop Trauma Surg. 2023 Dec;143(12):7169-7183. doi: 10.1007/s00402-023-04991-y. Epub 2023 Aug 11.
The component design and fixation method of joint arthroplasty may affect component migration and survival. The aim of this study was to compare fixation of cementless twin-peg (CLTP), cemented twin-peg (CTP) and cemented single-peg (CSP) femoral components of medial unicompartmental knee replacement (UKR).
Eighty patients (mean age = 63 years, 48 males) with medial knee osteoarthritis were randomized in three ways to CLTP (n = 25), CTP (n = 26) or CSP (n = 29) femoral UKR components. The patients were followed 5 years postoperatively with RSA, bone mineral density (BMD), PROMs and radiological evaluation of radiolucent lines (RLL), femoral component flexion angle and complications.
At the 5-year follow-up, femoral component total translation was comparable between the three groups (p = 0.60). Femoral component internal rotation was 0.50° (95% CI 0.3; 0.69) for the CLTP group, 0.58° (95% CI 0.38; 0.77) for the CTP group and 0.25° (95% CI 0.07; 0.43) for the CSP group (p = 0.01). BMD decreased peri-prosthetically (range - 11.5%; - 14.0%) until 6-month follow-up and increased toward the 5-year follow-up (range - 3.6%; - 5.8%). BMD change did not correlate with component migration. Lower flexion angle was correlated with higher 5-year subsidence, total translation, varus rotation and maximum total point motion (p = 0.01). Two patients (1 CLTP, 1 CTP) had RLL in the posterior zone. There were two revisions.
At 5-year follow-up, fixation of UKA femoral components with twin-peg was not superior to the single-peg design. Cementless and cemented twin-peg femoral components had similar fixation. A lower flexion angle was correlated with higher component migration.
关节置换的组件设计和固定方式可能会影响组件的迁移和存活。本研究旨在比较非骨水泥双钉（CLTP）、骨水泥双钉（CTP）和骨水泥单钉（CSP）固定的内侧单髁膝关节置换（UKR）股骨组件的固定效果。
80 例（平均年龄 63 岁，男性 48 例）内侧膝关节骨关节炎患者随机分为 CLTP（n=25）、CTP（n=26）或 CSP（n=29）三组接受 UKR 股骨组件治疗。患者术后 5 年采用 RSA、骨密度（BMD）、PROMs 和放射性透明线（RLL）、股骨组件弯曲角度以及并发症进行随访。
在 5 年随访时，三组之间股骨组件总迁移无显著差异（p=0.60）。CLTP 组股骨组件内旋 0.50°（95%CI 0.3；0.69），CTP 组为 0.58°（95%CI 0.38；0.77），CSP 组为 0.25°（95%CI 0.07；0.43）（p=0.01）。假体周围 BMD 在 6 个月随访时降低（范围-11.5%；-14.0%），在 5 年随访时增加（范围-3.6%；-5.8%）。BMD 变化与组件迁移无相关性。较低的弯曲角度与较高的 5 年沉降、总迁移、内翻旋转和最大总点运动相关（p=0.01）。两名患者（1 例 CLTP，1 例 CTP）后区出现 RLL。有 2 例翻修。
在 5 年随访时，UKA 股骨组件的双钉固定并不优于单钉设计。非骨水泥和骨水泥双钉股骨组件具有相似的固定效果。较低的弯曲角度与较高的组件迁移相关。
