Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, 250102, China.
Cheeloo College of Medicine, Shandong University, Jinan, 250102, China.
BMC Musculoskelet Disord. 2024 Jan 20;25(1):82. doi: 10.1186/s12891-024-07208-4.
The objective of this study was to investigate the correlation between lower limb alignment and patient outcomes after lateral unicompartmental knee arthroplasty (LUKA).
In this retrospective study, the information of 51 patients who underwent lateral UKA was collected after an average of 27months of follow-up (13 to 60 months). Evaluation indicators include the AKS and WOMAC score. The Kellgren-Lawrence grade is used to evaluate the severity of osteoarthritis, while the hip-knee-ankle (HKA) angle is utilized to measure the valgus angle of lower limb alignment.
Patients with postoperative valgus (≥ 3°) alignment had the best outcomes, while those with varus (≤-3°) alignment had the worst outcomes (p < 0.001). Furthermore, it was noted that patients with preoperative mild valgus (≤ 4°) alignment had worse postoperative outcomes than those with severe valgus (≥ 7°) alignment (p < 0.05). The study also revealed a positive correlation between postoperative valgus and WOMAC scores (p < 0.001), whereas a negative correlation was observed between the change in valgus angle and WOMAC scores (p = 0.005).
During follow-ups, we found that lower limb alignment seems to be an independent predictor of postoperative outcomes. It is recommended that more than 3° of valgus alignment should be maintained after LUKA. Surgeons performing lateral UKA should be cautious of overcorrecting alignment, particularly in patients with preoperative mild valgus alignment.
本研究旨在探讨外侧单髁膝关节置换(LUKA)后下肢对线与患者结局的相关性。
本回顾性研究共纳入 51 例接受外侧 UKA 治疗的患者,平均随访 27 个月(13-60 个月)。评估指标包括 AKS 和 WOMAC 评分。Kellgren-Lawrence 分级用于评估骨关节炎的严重程度,而髋膝踝(HKA)角用于测量下肢对线的外翻角度。
术后出现外翻(≥3°)对线的患者结局最佳,而出现内翻(≤-3°)对线的患者结局最差(p<0.001)。此外,术前轻度外翻(≤4°)对线的患者术后结局比重度外翻(≥7°)对线的患者更差(p<0.05)。研究还发现术后外翻与 WOMAC 评分呈正相关(p<0.001),而外翻角度的变化与 WOMAC 评分呈负相关(p=0.005)。
随访期间,我们发现下肢对线似乎是术后结局的独立预测因素。建议 LUKA 后维持 3°以上的外翻对线。行外侧 UKA 的术者应谨慎避免过度矫正对线,特别是在术前存在轻度外翻对线的患者中。