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肥胖患者中金属内侧支撑和全聚乙烯单间室膝关节置换术的中期结果:回顾性倾向评分匹配分析。

Mid-term outcomes of medial metal backed and all-polyethylene unicompartmental knee arthroplasty in obese patients: a retrospective propensity-matched analysis.

机构信息

Clinical Orthopaedics, Department of Clinical and Molecular Science, School of Medicine, Università Politecnica delle Marche, Ancona, Italy, Via Tronto, 10/a, 60126, Ancona, AN, Italy.

Department of Orthopaedics, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy.

出版信息

J Orthop Surg Res. 2024 Oct 14;19(1):651. doi: 10.1186/s13018-024-05148-2.

Abstract

BACKGROUND

This retrospective study compares the outcomes of unicompartmental medial fixed-bearing knee arthroplasty (mUKA), involving a cemented metal-backed (MB) or an all-polyethylene (AP) tibial component, performed in obese patients with a body mass index (BMI) > 30 with a follow-up of at least 5 years.

METHODS

The institutional database was mined for primary mUKAs involving an MB or an AP tibial component (MB-UKA and AP-UKA groups, respectively) performed from January 2015 to August 2019. Patient demographics and patient-reported outcome measures (PROMs) were compared and a propensity score matching (PSM) analysis (1:1) using multiple variables was conducted.

RESULTS

PSM analysis yielded 37 pairs of obese MB-UKA and AP-UKA patients. At 5 years, the Knee Society Function Score (KSFS) was 75.1 ± 10.6 in MB-UKA and 79.4 ± 9.1 in AP-UKA patients (p = 0.029), and the Oxford Knee Score (OKS) was 38.1 ± 4.4 in MB-UKA and 40.6 ± 5.7 in AP-UKA patients (p = 0.011).

CONCLUSION

At five-year follow-up, in a matched group of obese MB-UKA and AP-UKA patients, the AP-UKA group achieved better KSFSs and OKSs. Both the AP and the MB tibial components were able to bring about a significant improvement of the most widely used PROMs.

摘要

背景

本回顾性研究比较了单髁内侧固定轴承膝关节置换术(mUKA)在肥胖患者(BMI>30)中的治疗效果,随访时间至少 5 年。这些患者的胫骨组件分别为骨水泥固定的金属背衬(MB)或全聚乙烯(AP)。

方法

从 2015 年 1 月至 2019 年 8 月,对机构数据库中进行的原发性 mUKA 进行了挖掘,这些手术涉及 MB 或 AP 胫骨组件(MB-UKA 和 AP-UKA 组)。比较了患者的人口统计学和患者报告的结果测量(PROM),并使用多个变量进行了倾向评分匹配(PSM)分析(1:1)。

结果

PSM 分析得到了 37 对肥胖的 MB-UKA 和 AP-UKA 患者。在 5 年时,MB-UKA 患者的膝关节学会功能评分(KSFS)为 75.1±10.6,AP-UKA 患者为 79.4±9.1(p=0.029),牛津膝关节评分(OKS)在 MB-UKA 患者中为 38.1±4.4,AP-UKA 患者中为 40.6±5.7(p=0.011)。

结论

在 5 年的随访中,在肥胖的 MB-UKA 和 AP-UKA 患者的匹配组中,AP-UKA 组的 KSFS 和 OKS 更好。AP 和 MB 胫骨组件都能显著改善最广泛使用的 PROM。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d2a/11476603/81681ff828cc/13018_2024_5148_Fig1_HTML.jpg

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