Department of Orthopaedics, The Second People's Hospital of Changzhi City, No. 83, Heping West Street, Changzhi, Shanxi, 046000, China.
Graduate School, The First Clinical College of Changzhi Medical College, No. 161, Jiefang East Street, Changzhi, Shanxi, 046000, China.
Arch Orthop Trauma Surg. 2024 Sep;144(9):4391-4403. doi: 10.1007/s00402-024-05539-4. Epub 2024 Sep 19.
This meta-analysis sought to compare the efficacy of cemented versus cementless Oxford unicompartmental knee arthroplasty(UKA) for the treatment of medial knee osteoarthritis.
A comprehensive search of the following databases was conducted: Pubmed, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Embase, the Web of Science, and MEDLINE. The objective was to identify literature comparing cemented versus cementless Oxford unicompartmental knee arthroplasty for the treatment of medial knee osteoarthritis. Duplicate literature, low-quality literature, literature with incompatible observations, and literature for which the full text was not available were excluded. Two independent researchers employed the Cochrane Risk Assessment Tool and the Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included literature. The data then were extracted and subsequently meta-analyzed using RevMan 5.4.
A total of 12 papers were included in the analysis, encompassing a cumulative of 2558 cumulative cases. Of these, 1258 were cemented and 1300 were cementless. A meta-analysis was conducted to compare the outcomes of cemented versus cementless Oxford UKA. The Oxford UKA group exhibited a significantly longer surgery time than the cementless Oxford UKA group [mean difference (MD) = 9.91, 95% confidence interval (CI) (7.64,12.17)]. Additionally, the cemented Oxford UKA group demonstrated a significantly lower knee OKS score compared to the cementless Oxford UKA group. The mean difference (MD) was - 1.58 (95% CI: -2.30, -0.86), indicating a significantly lower score for the cemented Oxford UKA group. Similarly, the mean difference (MD) was - 1.8 for the knee KSS clinical score, indicating a significantly lower score for the cemented Oxford UKA group. The results demonstrated that the knee KSS functional score was significantly lower in the cemented Oxford UKA group than in the cementless Oxford UKA group [MD=-1.72, 95% CI (-3.26, -0.37)]. 95% CI (-3.27,-0.17)], the cemented Oxford UKA group exhibited a significantly higher incidence of radiolucent lines around the prosthesis than the cementless Oxford UKA group [ratio of ratios (OR) = 3.62, 95% CI (1.08,12.13)]. The revision rate was significantly higher in the cemented Oxford UKA group than in the cementless Oxford UKA group [OR = 2.22, 95% CI (1.40,3.53)]. However, no significant difference was observed between the two groups in terms of reoperation rate, five-year prosthesis survival rate, and complication rate.
The findings indicated that, in comparison to cemented Oxford UKA, cementless Oxford UKA resulted in a reduction in surgical time, an improvement in knee OKS score, KSS clinical score, and KSS functional score, and a decrease in the incidence of periprosthetic radiolucent lines and the rate of revisions.
本荟萃分析旨在比较骨水泥固定与非骨水泥固定 Oxford 单髁膝关节置换术（UKA）治疗内侧膝关节骨关节炎的疗效。
全面检索了以下数据库：Pubmed、The Cochrane Library、中国知网（CNKI）、Embase、Web of Science 和 MEDLINE。旨在确定比较骨水泥固定与非骨水泥固定 Oxford 单髁膝关节置换术治疗内侧膝关节骨关节炎的文献。排除重复文献、低质量文献、观察结果不一致的文献以及无法获取全文的文献。两名独立的研究人员使用 Cochrane 风险评估工具和 Newcastle-Ottawa 量表（NOS）评估纳入文献的质量。然后使用 RevMan 5.4 提取数据并进行荟萃分析。
共纳入 12 篇文献进行分析，累计病例 2558 例。其中，骨水泥固定组 1258 例，非骨水泥固定组 1300 例。对骨水泥固定 Oxford UKA 与非骨水泥固定 Oxford UKA 的结果进行荟萃分析。Oxford UKA 组手术时间明显长于非骨水泥固定 Oxford UKA 组[均数差（MD）=9.91，95%置信区间（CI）（7.64，12.17）]。此外，骨水泥固定 Oxford UKA 组的膝关节 OKS 评分明显低于非骨水泥固定 Oxford UKA 组。MD 为-1.58（95%CI：-2.30，-0.86），表明骨水泥固定 Oxford UKA 组评分明显较低。同样，膝关节 KSS 临床评分的 MD 为-1.8，表明骨水泥固定 Oxford UKA 组评分明显较低。结果表明，骨水泥固定 Oxford UKA 组的膝关节 KSS 功能评分明显低于非骨水泥固定 Oxford UKA 组[MD=-1.72，95%CI（-3.26，-0.37）]。95%CI（-3.27，-0.17）]，骨水泥固定 Oxford UKA 组假体周围出现透亮线的发生率明显高于非骨水泥固定 Oxford UKA 组[比值比（OR）=3.62，95%CI（1.08，12.13）]。骨水泥固定 Oxford UKA 组的翻修率明显高于非骨水泥固定 Oxford UKA 组[OR=2.22，95%CI（1.40，3.53）]。然而，两组之间的再手术率、五年假体生存率和并发症发生率无显著差异。
与骨水泥固定 Oxford UKA 相比，非骨水泥固定 Oxford UKA 可缩短手术时间，改善膝关节 OKS 评分、KSS 临床评分和 KSS 功能评分，降低假体周围透亮线发生率和翻修率。
