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[Interpretation of the expert consensus of the British Association for Surgery of the Knee (BASK) and the European Knee Society (EKS) on unicompartmental knee arthroplasty].[英国膝关节外科学会(BASK)与欧洲膝关节学会(EKS)关于单髁膝关节置换术的专家共识解读]
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Sep 15;38(9):1029-1034. doi: 10.7507/1002-1892.202405056.
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[Comparison of unicompartmental knee arthroplasty and total knee arthroplasty in the treatment of severe medial compartment osteoarthritis].单髁膝关节置换术与全膝关节置换术治疗重度内侧间室骨关节炎的比较
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Sep 15;35(9):1125-1132. doi: 10.7507/1002-1892.202103181.
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1
Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA.单间室膝关节置换术,一个谜,以及内侧 UKA 的十大谜。
J Orthop Traumatol. 2020 Sep 2;21(1):15. doi: 10.1186/s10195-020-00551-x.
2
Lateral and patellofemoral compartment osteoarthritis progression after medial unicompartmental knee arthroplasty: A five- to 10-year follow-up study.内侧单髁膝关节置换术后外侧间室和髌股关节骨关节炎的进展:一项 5 至 10 年的随访研究。
Knee. 2020 Aug;27(4):1135-1142. doi: 10.1016/j.knee.2020.05.021. Epub 2020 Jun 25.
3
Higher risk of revision for partial knee replacements in low absolute volume hospitals: data from 18,134 partial knee replacements in the Dutch Arthroplasty Register.低绝对手术量医院行膝关节部分置换术的翻修风险更高:来自荷兰关节置换登记处的 18134 例膝关节部分置换术数据。
Acta Orthop. 2020 Aug;91(4):426-432. doi: 10.1080/17453674.2020.1752017. Epub 2020 Apr 14.
4
The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial.全膝关节置换与部分膝关节置换治疗内侧间室骨关节炎患者的临床效果和成本效益(TOPKAT):一项随机对照试验的 5 年结果。
Lancet. 2019 Aug 31;394(10200):746-756. doi: 10.1016/S0140-6736(19)31281-4. Epub 2019 Jul 17.
5
Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement.关节镜半月板手术:国家学会治疗指南和共识声明。
Bone Joint J. 2019 Jun;101-B(6):652-659. doi: 10.1302/0301-620X.101B6.BJJ-2019-0126.R1.
6
Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis.单髁膝关节置换与全膝关节置换的患者相关结局:系统评价和荟萃分析。
BMJ. 2019 Feb 21;364:l352. doi: 10.1136/bmj.l352.
7
How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.人工膝关节置换的使用寿命有多长?一项超过 15 年随访的病例系列和国家登记报告的系统评价和荟萃分析。
Lancet. 2019 Feb 16;393(10172):655-663. doi: 10.1016/S0140-6736(18)32531-5. Epub 2019 Feb 14.
8
Update on unicompartmental knee arthroplasty: Current indications and failure modes.单髁膝关节置换术的最新进展:当前适应症及失败模式
EFORT Open Rev. 2018 Aug 1;3(8):442-448. doi: 10.1302/2058-5241.3.170060. eCollection 2018 Aug.
9
Disease Progression After Lateral and Medial Unicondylar Knee Arthroplasty.外侧和内侧单间室膝关节置换术后的疾病进展。
J Arthroplasty. 2018 Nov;33(11):3441-3447. doi: 10.1016/j.arth.2018.07.019. Epub 2018 Jul 29.
10
Eight Hundred Twenty-Five Medial Mobile-Bearing Unicompartmental Knee Arthroplasties: The First 10-Year US Multi-Center Survival Analysis.八百二十五例内侧间室活动平台型膝关节单髁置换术:美国首个 10 年多中心生存分析。
J Arthroplasty. 2018 Mar;33(3):677-683. doi: 10.1016/j.arth.2017.10.015. Epub 2017 Oct 16.

[英国膝关节外科学会(BASK)与欧洲膝关节学会(EKS)关于单髁膝关节置换术的专家共识解读]

[Interpretation of the expert consensus of the British Association for Surgery of the Knee (BASK) and the European Knee Society (EKS) on unicompartmental knee arthroplasty].

作者信息

Ma Jun, Si Haibo, Zeng Yi, Huang Qiang, Shen Bin

机构信息

Department of Orthopedic Surgery/Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Sep 15;38(9):1029-1034. doi: 10.7507/1002-1892.202405056.

DOI:10.7507/1002-1892.202405056
PMID:39300874
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11440159/
Abstract

Unicompartmental knee arthroplasty (UKA) has a long history and has many advantages in some aspects over total knee arthroplasty (TKA) for patients with suitable indications, but it has not been established as a treatment at the same level with TKA. Therefore, 80 members of the British Association for Surgery of the Knee (BASK) and the European Knee Society (EKS) were invited to attend a joint meeting with the aim of creating an evidence-based consensus statement on UKA, in London, UK (December 2019). A formal consensus process was undertaken at the meeting incorporating a multiple round Delphi exercise, with group discussion of areas of agreement and disagreement between rounds. Five consensus statements were issued: ① UKA should be offered as a successful alternative to TKA in patients undergoing arthroplasty who meet agreed indications. ② When consenting a patient for UKA, information including the benefits and risks that are specific to UKA, should be tailored to and discussed with the individual patient. ③ Evidence suggests that surgeons should avoid low-volume use of UKA to optimise outcomes for their patients. ④ Surgeons should use the contemporary evidence-based indications and contraindications for medial UKA. ⑤ Knee arthroplasty surgeons should have exposure to and training in UKA. On the basis of full study of the consensus, combined with the Expert Consensus on Perioperative Management of Unicompartmental Knee Arthroplasty in China in 2020, this paper elaborates the meaning of the final evidence-based consensus for clinicians' reference.

摘要

单髁膝关节置换术(UKA)历史悠久,对于有合适适应症的患者,在某些方面比全膝关节置换术(TKA)有诸多优势,但尚未被确立为与TKA处于同一水平的治疗方法。因此,英国膝关节外科学会(BASK)和欧洲膝关节学会(EKS)的80名成员受邀参加了一次联合会议,目的是就UKA制定一份基于证据的共识声明,会议于2019年12月在英国伦敦举行。会议采用了正式的共识达成过程,包括多轮德尔菲法,并在各轮之间对达成一致和存在分歧的领域进行小组讨论。发布了五项共识声明:①对于符合商定适应症的接受关节置换术的患者,UKA应作为TKA的一种成功替代方案提供。②在为患者进行UKA手术同意时,应根据个体患者情况定制并讨论包括UKA特有的益处和风险在内的信息。③有证据表明,外科医生应避免低手术量地使用UKA,以优化患者的治疗效果。④外科医生应使用当代基于证据的内侧UKA适应症和禁忌症。⑤膝关节置换外科医生应接触并接受UKA方面的培训。在充分研究该共识的基础上,结合2020年中国单髁膝关节置换术围手术期管理专家共识,本文阐述了最终基于证据的共识对临床医生的参考意义。