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 Sep;144(9):4247-4257. doi: 10.1007/s00402-024-05514-z. Epub 2024 Sep 10.
Lateral unicompartmental knee arthroplasties (LUKA) account for only < 1% of all knee arthroplasties and for only 5-10% of all unicompartmental knee replacements. This means that there is less published literature on these procedures and that the surgeon's experience with them is smaller than with medial UKA. The aim of this study was to analyze the survival and the clinical-functional outcomes of LUKA according to the type of bearing surface (all-polyethylene versus metal-backed) used.
This was a retrospective study including 42 LUKAs operated between 2009 and 2021. Two fixed polyethylene-bearing models were used: the all-polyethylene ACCURIS knee (38%) and the metal-backed Triathlon PKR system (62%). Demographic parameters, knee range of motion (ROM), tibiofemoral alignment, implant survival (as estimated with the Kaplan-Meier curve), and clinical-functional outcomes (as measured with the Knee Society Score) were analyzed.
Average patient age was 65.5 (range, 36-87) years and mean follow-up was 8.2 (range, 2.1-12.8) years. Thirty LUKAs (71.4%) were implanted in women. The main reason for performing a LUKA was osteoarthritis (88.1%). No patient developed post-surgical complications or had to be re-operated. Overall LUKA survival was 100% at 1-year and 5-year's follow-up. Knee Society Score, knee ROM and tibiofemoral alignment all improved significantly post-surgery (p < 0.001). The clinical Knee Society Score increased from 46.5 ± 14.5 pre-surgery to 93.5 ± 10.3 post-surgery, the functional Knee Society Score increased from 48.1 ± 13.5 pre-surgery to 94.6 ± 9.3 post-surgery, maximum flexion increased from 108.5 ± 8.7 degrees pre-surgery to 121 ± 8.9 degrees post-surgery and tibiofemoral alignment was corrected from 13.1 ± 1.74 degrees pre-surgery to 5.7 ± 0.8 degrees post-surgery. There were no statistically significant clinical-functional improvement or knee ROM differences between groups (p < 0.05, respectively).
LUKA is a valid and definitive option for patients with lateral tibiofemoral osteoarthritis, with a survival rate of > 95% at 5-years follow-up. Clinical-functional outcomes are the same, irrespective of the tibial component used.
外侧单髁膝关节置换术（LUKA）仅占所有膝关节置换术的 < 1%，占所有单髁膝关节置换术的 5-10%。这意味着关于这些手术的文献较少，外科医生的经验也比内侧 UKA 少。本研究的目的是根据使用的轴承表面类型（全聚乙烯与金属背衬）分析 LUKA 的生存率和临床功能结果。
这是一项回顾性研究，包括 2009 年至 2021 年间进行的 42 例 LUKA。使用了两种固定聚乙烯轴承模型：全聚乙烯 ACCURIS 膝关节（38%）和金属背衬 Triathlon PKR 系统（62%）。分析了人口统计学参数、膝关节活动范围（ROM）、胫股对线、植入物存活率（用 Kaplan-Meier 曲线估计）和临床功能结果（用膝关节协会评分测量）。
平均患者年龄为 65.5 岁（范围，36-87 岁），平均随访时间为 8.2 年（范围，2.1-12.8 年）。30 例 LUKA（71.4%）植入女性。进行 LUKA 的主要原因是骨关节炎（88.1%）。没有患者发生术后并发症或需要再次手术。LUKA 的总体生存率在 1 年和 5 年的随访中均为 100%。术后膝关节协会评分、膝关节 ROM 和胫股对线均显著改善（p < 0.001）。临床膝关节协会评分从术前的 46.5 ± 14.5 增加到术后的 93.5 ± 10.3，功能膝关节协会评分从术前的 48.1 ± 13.5 增加到术后的 94.6 ± 9.3，最大屈曲度从术前的 108.5 ± 8.7 度增加到术后的 121 ± 8.9 度，胫股对线从术前的 13.1 ± 1.74 度校正到术后的 5.7 ± 0.8 度。组间临床功能改善或膝关节 ROM 无统计学意义（p < 0.05，分别）。
对于外侧胫股关节炎患者，LUKA 是一种有效的确定性选择，5 年随访的生存率超过 95%。无论使用哪种胫骨组件，临床功能结果都是相同的。
