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严重外侧髌股关节骨关节炎与外侧单髁膝关节置换术后平均10年失败率增加无关。

Severe Lateral Facet Patella Osteoarthritis Is Not Associated With Increased Failure at Mean 10 Years After Lateral Unicompartmental Knee Arthroplasty.

作者信息

Plancher Kevin D, Comulada David B, DiVella Micheal F, Briggs Karen K, Schwartz Elias N, Mannina Carlo M, Petterson Stephanie C

机构信息

Plancher Orthopaedics & Sports Medicine, New York, New York; Albert Einstein College of Medicine, New York, New York; Weil Cornell Medical College, New York, New York; Orthopaedic Foundation, Stamford, Connecticut.

Plancher Orthopaedics & Sports Medicine, New York, New York; Orthopaedic Foundation, Stamford, Connecticut.

出版信息

J Arthroplasty. 2025 Feb;40(2):359-366. doi: 10.1016/j.arth.2024.08.004. Epub 2024 Aug 14.

DOI:10.1016/j.arth.2024.08.004
PMID:39128779
Abstract

BACKGROUND

The purpose of this study was to determine if severe lateral patella facet osteoarthritis was related to lower survivorship and poor patient-reported outcomes following fixed-bearing lateral unicompartmental knee arthroplasty (UKA).

METHODS

There were 61 patients who underwent a fixed-bearing, nonrobotically assisted, lateral UKA between May 7, 2003 and December 18, 2019 and met the inclusion criteria. The patello-femoral joint was examined intraoperatively for chondral damage prior to UKA implantation. Severe lateral facet patella osteoarthritis (LFPOA) was defined as Outerbridge grades 3 or 4 changes on the lateral facet. All patients completed subjective functional outcomes questionnaires and a clinical examination at a minimum of 4 years following UKA.

RESULTS

Severe LFPOA was identified in 28 (46%) patients. At a mean follow-up of 10.9 years, there were no statistically significant differences in any Knee Osteoarthritis Outcomes Score (KOOS) subscale or Kujala scores between patients who had and did not have severe LFPOA. There was no statistically significant difference in the percentage of patients who achieved Patient Acceptable Symptom State for the KOOS subscale scores between groups. Mean survival in patients who did not have severe LFPOA was 16.6 years (95% confidence interval, 15.4 to 17.7) compared to 18.9 years (95% confidence interval, 17.6 to 20.2) in patients who had severe LFPOA (P = 0.62).

CONCLUSIONS

Severe LFPOA did not result in lower survival or inferior functional outcomes compared to patients who did not have severe osteoarthritis at an average 10-year follow-up after fixed-bearing lateral UKA.

摘要

背景

本研究的目的是确定严重的外侧髌股关节面骨关节炎是否与固定平台外侧单髁膝关节置换术(UKA)后较低的假体生存率及患者报告的不良预后相关。

方法

2003年5月7日至2019年12月18日期间,61例患者接受了固定平台、非机器人辅助的外侧UKA手术,且符合纳入标准。在UKA植入前,术中检查髌股关节软骨损伤情况。严重外侧髌股关节面骨关节炎(LFPOA)定义为外侧关节面Outerbridge分级为3级或4级改变。所有患者在UKA术后至少4年完成主观功能结局问卷和临床检查。

结果

28例(46%)患者被诊断为严重LFPOA。平均随访10.9年,有和没有严重LFPOA的患者在任何膝关节骨关节炎结局评分(KOOS)子量表或库贾拉评分上均无统计学显著差异。两组间达到KOOS子量表评分的患者可接受症状状态百分比无统计学显著差异。没有严重LFPOA的患者平均假体生存率为16.6年(95%置信区间,15.4至17.7),而有严重LFPOA的患者为18.9年(95%置信区间,17.6至20.2)(P = 0.62)。

结论

在固定平台外侧UKA术后平均10年的随访中,与没有严重骨关节炎的患者相比,严重LFPOA并未导致更低的假体生存率或更差的功能结局。

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引用本文的文献

1
The impact of patellofemoral joint diseases on functional outcomes and prosthesis survival in patients undergoing unicompartmental knee arthroplasty: a systematic review and meta-analysis.髌股关节疾病对单髁膝关节置换术患者功能结局和假体生存率的影响:一项系统评价和荟萃分析。
J Orthop Surg Res. 2024 Dec 19;19(1):840. doi: 10.1186/s13018-024-05273-y.