Hao Yu, Li Jia, Li Jun, Zhao Feng, Yu Xiaoguang, Liang Shunlong, Zhang Chenda, Dong Wei, Liu Guobin
Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, NO. 89 Donggang Road, Shijiazhuang, 063000, Hebei, P. R. China.
Hebei Medical University, Shijiazhuang, 050011, Hebei, P. R. China.
Sci Rep. 2024 Dec 28;14(1):30953. doi: 10.1038/s41598-024-81995-7.
The risks and benefits associated with simultaneous bilateral unicompartmental knee arthroplasty (UKA) continue to engender contentious debate. The aim of this study was to compare the clinical outcomes of simultaneous bilateral and unilateral UKA. A retrospective review was performed between 2019 and 2022 on 280 patients (130 simultaneous bilateral vs. 150 unilateral Oxford UKA) who performed by two experienced surgeons. Patients in both groups underwent surgery according to the Microplasty instrumentation system, with congruent postoperative management and carefully standardized follow-up. This study performed a comparative analysis between the two groups of patients with regard to postoperative laboratory tests, knee functionality, postoperative discomfort, and incidence of complications. There was a significant difference in the duration of disease between the two groups (U-UKA:6.05 vs. SB-UKA:7.80, P < 0.05). When it comes to laboratory examinations, a notable disparity emerged in hemoglobin levels, erythrocyte pressure volume, D-dimer concentrations, albumin levels, as well as indicators of inflammation among the two groups of patients (P < 0.05). There was a significant difference in operative time and blood loss between the two groups (P < 0.05), with no significant difference in complications. There was no significant difference in radiographic and prosthetic survival between the two groups (U-UKA: 99.3% vs. 98.5%). The HSS score, VAS, and ROM showed remarkable disparities between the two groups in the initial postoperative phase, albeit these distinctions gradually attenuated with the passage of time. Simultaneous bilateral UKA reduces the number of procedures without increasing the risk of surgical complications, but results in a markedly enhanced physiological response and a suboptimal perioperative experience. We strongly encourage the surgeon to work with the patient to determine a surgical strategy.
同期双侧单髁膝关节置换术(UKA)的风险和益处仍存在争议。本研究旨在比较同期双侧和单侧UKA的临床疗效。对2019年至2022年间由两位经验丰富的外科医生实施手术的280例患者(130例同期双侧与150例单侧牛津UKA)进行了回顾性分析。两组患者均根据微创器械系统进行手术,术后管理一致且随访严格标准化。本研究对两组患者的术后实验室检查、膝关节功能、术后不适及并发症发生率进行了比较分析。两组患者的病程存在显著差异(单侧UKA:6.05年 vs. 双侧UKA:7.80年,P < 0.05)。在实验室检查方面,两组患者的血红蛋白水平、红细胞压积、D - 二聚体浓度、白蛋白水平以及炎症指标存在显著差异(P < 0.05)。两组患者的手术时间和失血量存在显著差异(P < 0.05),并发症方面无显著差异。两组患者的影像学检查和假体生存率无显著差异(单侧UKA:99.3% vs. 双侧UKA:98.5%)。在术后初期,两组患者的HSS评分、视觉模拟评分(VAS)和关节活动度(ROM)存在显著差异,不过随着时间推移这些差异逐渐减小。同期双侧UKA减少了手术次数,且未增加手术并发症风险,但会导致明显增强的生理反应和欠佳的围手术期体验。我们强烈建议外科医生与患者共同确定手术策略。