Clínica COT, C/ Juan Ramón Jiménez 29, 41011, Seville, Spain.
Orthopedics and Trauma Surgery Department, Viamed Santa Ángela de la Cruz Hospital, Av. de Jerez, 59, 41014, Seville, Spain.
Arch Orthop Trauma Surg. 2024 Jan;144(1):347-355. doi: 10.1007/s00402-023-05055-x. Epub 2023 Sep 25.
Few information has been published on the survival of unicompartmental knee arthroplasty (UKA) and fixed-bearing tibial components. The aim of this study is to analyze if UKA survival varies according to UKA model used and to analyze the possible risk factors for UKA revision.
A retrospective study analyzing 301 UKAs (ACCURIS, all-polyethylene tibial component, 152; Triathlon PKR, metal-backed tibial component, 149) was performed. Demographic parameters as well as implant survival and cause of prosthetic revision were analyzed. The Kaplan-Meier survival analysis, the log-rank test and the Cox multiple regression were used for the analysis.
Average follow-up was 8.1 ± 3.08-years. Average age was 68.1 ± 8.6-years; 70.4% of subjects were women. The ACCURIS UKA group had a UKA revision rate higher compared to the Triathlon PKR group (16/152, 10.6% vs 5/149, 3.4%, respectively; p < 0.001). The main cause of prosthetic revision was aseptic loosening (5/21, 23.8%). All aseptic loosening cases and tibial component collapse were reported with the ACCURIS UKA group. Overall UKA survival was 98.01% (95% CI 95.62-99.1) at 1-year, 94.27% (95% CI 90.95-96.4) at 5-years and 92.38% (95% CI 88.48-94.99) at 10-years' follow-up. There were no differences in the Kaplan-Meier survival curves regarding operated side or affected tibiofemoral compartment (log-rank test = 0.614 and 0.763, respectively). However, Kaplan-Meier survival curve according to UKA model used was different (log-rank test = 0.033). The metal-backed component appeared to be a protector factor for UKA revision when adjusted for age, sex, operated side, and affected tibiofemoral compartment (Hazard Ratio 0.32, p = 0.031).
Fixed-bearing UKAs showed excellent mid- and long-term survival rates. Aseptic loosening is the main cause of implant failure. PKR group (metal-backed component) seem to be a protector factor to UKA revision when it was compared with ACCURIS UKA group (all-polyethylene tibial component).
关于单髁膝关节置换术 (UKA) 和固定轴承胫骨组件的生存率，鲜有信息公布。本研究旨在分析 UKA 生存率是否因所使用的 UKA 模型而异，并分析 UKA 翻修的可能危险因素。
对 301 例 UKA（ACCURIS，全聚乙烯胫骨组件，152 例；Triathlon PKR，金属背衬胫骨组件，149 例）进行回顾性研究。分析了人口统计学参数以及假体的生存率和翻修原因。使用 Kaplan-Meier 生存分析、对数秩检验和 Cox 多因素回归进行分析。
平均随访 8.1±3.08 年。平均年龄为 68.1±8.6 岁；70.4%的患者为女性。与 Triathlon PKR 组相比，ACCURIS UKA 组的 UKA 翻修率更高（16/152，10.6%比 5/149，3.4%；p<0.001）。假体翻修的主要原因是无菌性松动（5/21，23.8%）。所有无菌性松动和胫骨组件塌陷病例均发生在 ACCURIS UKA 组。整体 UKA 生存率为 1 年时 98.01%（95%CI 95.62-99.1），5 年时 94.27%（95%CI 90.95-96.4），10 年时 92.38%（95%CI 88.48-94.99）。根据手术侧或受累胫股关节室，Kaplan-Meier 生存曲线无差异（对数秩检验分别为 0.614 和 0.763）。然而，根据所使用的 UKA 模型，Kaplan-Meier 生存曲线不同（对数秩检验为 0.033）。金属背衬组件在调整年龄、性别、手术侧和受累胫股关节室后，似乎是 UKA 翻修的保护因素（风险比 0.32，p=0.031）。
固定轴承 UKA 显示出优异的中、长期生存率。无菌性松动是植入物失败的主要原因。与 ACCURIS UKA 组（全聚乙烯胫骨组件）相比，PKR 组（金属背衬组件）似乎是 UKA 翻修的保护因素。
