Department of Orthopaedic Surgery, North Shore Hospital, Private Bag 93-503, Auckland, 0620, New Zealand.
Department of Surgery, Faculty of Medical and Health Sciences (FMHS), University of Auckland, Private bag 92019, Auckland, 1023, New Zealand.
Arch Orthop Trauma Surg. 2024 Sep;144(9):4053-4058. doi: 10.1007/s00402-024-05441-z. Epub 2024 Jul 15.
Arthroscopic procedures for osteoarthritis (OA), in particular arthroscopic meniscectomy, have poorer long-term clinical outcomes compared to those managed non-operatively. In addition, previous arthroscopy is associated with worse outcomes following subsequent total knee arthroplasty (TKA), however there is limited data on the impact on subsequent unicompartmental knee arthroplasty (UKA) outcomes. The aim of the study is to investigate whether patients who had arthroscopy prior to UKA have differences in survivorship or functional outcomes compared to those with no prior arthroscopy.
All patients who received either a primary medial or lateral UKA at four large tertiary hospitals were included (n = 2,272). Patient data (age, sex, ethnicity, body mass index (BMI), American Society of Anesthesiologists (ASA) status and surgical data) was recorded following systematic review of all clinical notes and radiographs. Differences between survival curves were analysed using log-rank curves. Differences between categorical data was compared using Fisher's exact or Chi-squared tests, and differences between continuous variables were compared using t-tests.
There was no difference between the survival curves for UKA patients with previous arthroscopy compared to those with no previous arthroscopy (10 years: 91% UKA with previous arthroscopy vs. 92% no previous arthroscopy; 15 years: 78% previous arthroscopy vs. 86% no previous arthroscopy; p = 0.50). Oxford Knee Score (OKS) was comparable between patients who had previous arthroscopy and those who had no previous arthroscopy at 6 months (38.8 vs. 39.3, p = 0.45), 5 years (42.0 vs. 40.4, p = 0.11) and 10 years (40.8 vs. 40.2, p = 0.71).
In this large patient cohort with comprehensive review of clinical data and outcomes, we found that prior arthroscopy did not affect survivorship or functional outcomes of UKA patients.
与非手术治疗相比，关节镜治疗骨关节炎（OA），特别是关节镜半月板切除术，其长期临床结果较差。此外，先前的关节镜检查与随后的全膝关节置换术（TKA）后的结果较差相关，但是关于对随后的单髁膝关节置换术（UKA）结果的影响的数据有限。该研究的目的是调查 UKA 之前进行过关节镜检查的患者与未进行过关节镜检查的患者相比，在生存率或功能结果方面是否存在差异。
所有在四家大型三级医院接受初次内侧或外侧 UKA 的患者均被纳入研究（n=2272）。通过对所有临床记录和 X 线片进行系统回顾，记录患者数据（年龄、性别、种族、体重指数（BMI）、美国麻醉医师协会（ASA）状态和手术数据）。使用对数秩曲线分析生存曲线之间的差异。使用 Fisher 精确检验或卡方检验比较分类数据之间的差异，使用 t 检验比较连续变量之间的差异。
在有或没有先前关节镜检查的 UKA 患者之间，生存曲线之间没有差异（10 年：UKA 有先前关节镜检查的患者为 91%，而没有先前关节镜检查的患者为 92%；15 年：先前关节镜检查的患者为 78%，而没有先前关节镜检查的患者为 86%；p=0.50）。在 6 个月（38.8 对 39.3，p=0.45）、5 年（42.0 对 40.4，p=0.11）和 10 年（40.8 对 40.2，p=0.71）时，有先前关节镜检查的患者和没有先前关节镜检查的患者的牛津膝关节评分（OKS）相当。
在这项具有全面临床数据和结果回顾的大型患者队列研究中，我们发现先前的关节镜检查并未影响 UKA 患者的生存率或功能结果。
