Montagna Alice, Andriollo Luca, Sangaletti Rudy, Benazzo Francesco, Rossi Stefano Marco Paolo
University of Pavia, Pavia, Italy.
Sezione di Chirurgia Protesica ad Indirizzo Robotico Unità di Traumatologia dello Sport, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Arch Orthop Trauma Surg. 2024 Dec 27;145(1):95. doi: 10.1007/s00402-024-05741-4.
Unicompartmental knee arthroplasty (UKA) is a viable option for localized osteoarthritis (OA) or avascular osteonecrosis with several advantages over total knee arthroplasty (TKA). UKA implants may feature a tibial component either all-polyethylene (AP) or metal-backed (MB). This study aims to retrospectively compare the clinical outcomes and survivorship of 74 UKAs over 16 years, focusing on comparing the results and survivorship of MB versus AP tibial tray.
This retrospective study assesses 74 patients who underwent medial unicompartmental knee arthroplasty (UKA) using ACCURIS Uni Knee System (Smith & Nephew, Memphis, TN, USA) implants between January 2003 and December 2008. Patients were divided in two groups: all-polyethylene (AP) tibial implants and metal-backed (MB) tibial components. The two groups were compared at final follow-up regarding survivorship, revision rates and clinical outcomes using the WOMAC score, Oxford Knee Score (OKS) and Forgotten Joint Score (FJS-12).
Between January 2003 and December 2008, 74 medial unicompartmental knee arthroplasties were implanted in 74 patients. Clinical outcomes were assessed with a mean follow-up of 214.4 months. The implant survivorship was 97.3% for the MB-UKAs and 94.6% for the AP-UKAs (p = 0.55). The average OKS in the MB-UKAs was 42, while in the AP-UKAs 41.6 (p = 0.53), with a total of 64.9% of patients exhibiting excellent outcomes (OKS > 41) and 35.1% showing good outcomes (OKS: 34-41). The average FJS-12 at final follow-up was 81.5 for the MB-UKAs and 82.3 for the AP-UKAs (p = 0.34). The average WOMAC score was 20. 9 for the MB-UKAs and 22.4 for the AP-UKAs (p = 0.55). No statistically significant differences were found between AP-UKAs and MB-UKAs in terms of patient demographics, surgical indications, or clinical outcomes.
This research demonstrated outstanding implant durability and favorable outcomes during extended follow-up periods for both cohorts undergoing medial UKA utilizing the original fixed bearing Cartier design. The results regarding both survivorship and PROMs were equivalent the AP group and the MB group.
单髁膝关节置换术（UKA）是治疗局限性骨关节炎（OA）或缺血性骨坏死的一种可行选择，与全膝关节置换术（TKA）相比具有多个优势。UKA植入物的胫骨部件可能采用全聚乙烯（AP）或金属背衬（MB）材质。本研究旨在回顾性比较74例UKA患者16年的临床结果和生存率，重点比较MB与AP胫骨托的结果和生存率。
这项回顾性研究评估了2003年1月至2008年12月期间使用ACCURIS Uni Knee系统（美国田纳西州孟菲斯市史赛克公司）植入物接受内侧单髁膝关节置换术（UKA）的74例患者。患者分为两组：全聚乙烯（AP）胫骨植入物组和金属背衬（MB）胫骨部件组。在末次随访时，使用WOMAC评分、牛津膝关节评分（OKS）和遗忘关节评分（FJS - 12）对两组的生存率、翻修率和临床结果进行比较。
2003年1月至2008年12月期间，74例患者接受了74例内侧单髁膝关节置换术。平均随访214.4个月后评估临床结果。MB - UKA组的植入物生存率为97.3%，AP - UKA组为94.6%（p = 0.55）。MB - UKA组的平均OKS为42，而AP - UKA组为41.6（p = 0.53），共有64.9%的患者结果为优（OKS > 41），35.1%的患者结果为良（OKS：34 - 41）。末次随访时，MB - UKA组的平均FJS - 12为81.5，AP - UKA组为82.3（p = 0.34）。MB - UKA组的平均WOMAC评分为20.9，AP - UKA组为22.4（p = 0.55）。在患者人口统计学、手术指征或临床结果方面，AP - UKA组和MB - UKA组之间未发现统计学上的显著差异。
本研究表明，对于采用原始固定承重卡地亚设计进行内侧UKA的两个队列，在延长随访期内植入物耐久性良好且结果令人满意。在生存率和患者报告结局测量指标方面，AP组和MB组的结果相当。
