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全聚乙烯胫骨组件在单髁膝关节置换术中具有优异的短期随访生存率和临床结果:一项多中心回顾性临床研究。

All-Polyethylene Tibial Component in Unicompartmental Knee Arthroplasty Offers Excellent Survivorship and Clinical Outcomes at Short-Term Follow-Up: A Multicenter Retrospective Clinical Study.

机构信息

IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy.

出版信息

Medicina (Kaunas). 2024 Sep 4;60(9):1451. doi: 10.3390/medicina60091451.

Abstract

: The ten-year survivorship of unicompartmental knee arthroplasty (UKA) is up to 96%, varying from implants and hospitals; however, most of registry studies do not distinguish between metal-back (MB) tibial implants and all-polyethylene (AP) tibial implants. The aim of the present retrospective clinical study was to analyze the clinical outcomes and survivorship of medial and lateral UKA with a newly designed all-polyethylene tibial plateau at short-term follow-up. : A retrospective analysis of prospectively collected consecutive patients who underwent medial or lateral UKA with AP tibial plateau was conducted, with a minimum follow-up of 1 year. Primary outcomes were clinical score (VAS, OKS, and KOOS) variations from baseline up to the latest follow-up. Secondary outcomes were Likert scale variations from baseline to the follow-up, evaluation of the influence of demographic factors (age and BMI) at the time of surgery on the clinical outcomes, and evaluation of revision rate up to the last follow-up. : The final study population included 99 knees. The mean VAS score for the medial group significantly decreased from 7.61 ± 1.65 (pre-intervention) to 2.74 ± 2.26 (post-intervention). Similar improvements were registered for the OKS as well, for both the medial group (from 22.5 ± 12.6 to 36.6 ± 10.6, with a delta of 14.11 (10.05 to 18.17)) and the lateral group (from 22.6 ± 12.6 to 36.9 ± 11.8, with a delta of 14.24 (8.65 to 19.83)). Moreover, all the KOOS subscales reported an amelioration, both in medial UKA and lateral UKA. Furthermore, a logistic regression of delta VAS was performed in relation to the other clinical questionnaires and the demographic factors. For both medial and lateral UKAs, no statistically significant correlation was found between the VAS scale regression and the demographic factors. The survival rate free from any revision of the cohort at the latest follow-up was 96.32%. : All-polyethylene tibial component in unicompartmental knee arthroplasty demonstrates significant improvements in clinical scores and a low failure rate at short-term follow-up.

摘要

: 单髁膝关节置换术 (UKA) 的 10 年存活率高达 96%,具体取决于植入物和医院;然而,大多数登记研究并没有区分金属背 (MB) 胫骨植入物和全聚乙烯 (AP) 胫骨植入物。本回顾性临床研究的目的是分析短期随访时使用新型全聚乙烯胫骨平台的内侧和外侧 UKA 的临床结果和存活率。: 对接受内侧或外侧 UKA 伴 AP 胫骨平台的连续前瞻性患者进行回顾性分析,随访时间至少 1 年。主要结果是从基线到最新随访时临床评分 (VAS、OKS 和 KOOS) 的变化。次要结果是从基线到随访时 Likert 量表的变化,评估手术时的人口统计学因素 (年龄和 BMI) 对临床结果的影响,以及到最后随访时的翻修率。: 最终的研究人群包括 99 例膝关节。内侧组的 VAS 评分从 7.61 ± 1.65(干预前)显著降低至 2.74 ± 2.26(干预后)。OKS 也有类似的改善,内侧组(从 22.5 ± 12.6 到 36.6 ± 10.6,差值为 14.11(10.05 至 18.17))和外侧组(从 22.6 ± 12.6 到 36.9 ± 11.8,差值为 14.24(8.65 至 19.83))。此外,内侧 UKA 和外侧 UKA 的所有 KOOS 亚量表均有改善。此外,还对 VAS 差值与其他临床问卷和人口统计学因素进行了逻辑回归分析。对于内侧和外侧 UKA,VAS 量表回归与人口统计学因素之间均无统计学显著相关性。在最新随访时,队列中无任何翻修的生存率为 96.32%。: 在短期随访中,全聚乙烯胫骨组件在单髁膝关节置换术中显示出临床评分的显著改善和低失败率。

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本文引用的文献

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All-Polyethylene Versus Metal-Backed Tibial Components in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials.
J Arthroplasty. 2024 May;39(5):1353-1360. doi: 10.1016/j.arth.2023.10.058. Epub 2023 Nov 4.
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Does Implant Design Influence Failure Rate of Lateral Unicompartmental Knee Arthroplasty? A Meta-Analysis.
J Arthroplasty. 2022 May;37(5):985-992.e3. doi: 10.1016/j.arth.2022.01.068. Epub 2022 Feb 1.
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Unicompartmental knee arthroplasty: all-poly versus metal-backed tibial component-a long-term follow-up study.
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