Liu Qian, Ren Jianhua, Zhang Wenhui, Liang Tangzhao, Wang Zhe, Xie Siwei, Li Yuhang, Hou Jianfeng, Wang Kun, He Ronghan
Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Orthop Surg. 2025 Feb;17(2):603-613. doi: 10.1111/os.14346. Epub 2025 Jan 5.
Gap balancing is a vital process during mobile-bearing unicompartmental knee arthroplasty (MB-UKA). However, this process commonly depends on the surgeon's experience and lacks specific unified standards. This study aimed to propose and evaluate a novel "measured resection" method for gap balance in MB-UKA.
This prospective study included 49 consecutive patients (52 knees) who underwent MB-UKA from February 1, 2023, to September 1, 2023. Gap balance was achieved by the traditional "two-finger" method (Group 1, 26 knees) or the measured resection method (Group 2, 26 knees). The novel "measured resection" method was performed by measuring the thickness of the resected posterior femoral condyle and resected medial posterior tibial plateau to assess proper meniscal bearing thickness. Data were collected at baseline and the 6-month follow-up. Prosthetic angles, range of motion (ROM), visual analog scale (VAS) score, Oxford knee score (OKS), and Global Perceived Scale (GPE) were used to evaluate clinical outcomes. Independent samples t-test and Mann-Whitney U test were used to compare the differences.
There were significant improvements in all measured outcomes at the 6-month follow-up from baseline in both groups (p < 0.01). Patients using measured resection method showed better ROM (130° vs. 120°, p = 0.007), VAS score (1 vs. 2, p = 0.013), and OKS scores (39.9 vs. 38.1, p = 0.013) at 6-month follow-up than the traditional "two-finger" method group. The prosthetic angles, ROM improvement, and GPE showed no significant difference between the groups (p > 0.05).
The measured resection method is a reliable method for assisting surgeons in choosing the ideal meniscal bearing thickness in MB-UKA to achieve proper gap balance and gain better clinical outcomes.
ClinicalTrials.gov (NCT03815448).
间隙平衡是活动平台单髁膝关节置换术（MB-UKA）中的关键步骤。然而，这一过程通常依赖于外科医生的经验，缺乏具体统一的标准。本研究旨在提出并评估一种用于MB-UKA间隙平衡的新型“测量截骨”方法。
这项前瞻性研究纳入了2023年2月1日至2023年9月1日期间连续接受MB-UKA手术的49例患者（52膝）。间隙平衡通过传统的“两指”方法（第1组，26膝）或测量截骨方法（第2组，26膝）实现。新型“测量截骨”方法通过测量切除的股骨后髁和切除的胫骨后内侧平台的厚度来评估合适的半月板承重厚度。在基线和6个月随访时收集数据。使用假体角度、活动范围（ROM）、视觉模拟评分（VAS）、牛津膝关节评分（OKS）和整体感知量表（GPE）来评估临床结果。采用独立样本t检验和曼-惠特尼U检验比较差异。
两组在6个月随访时所有测量结果较基线均有显著改善（p < 0.01）。在6个月随访时，采用测量截骨方法的患者的ROM（130°对120°，p = 0.007）、VAS评分（1对2，p = 0.013）和OKS评分（39.9对38.1，p = 0.013）均优于传统“两指”方法组。两组之间的假体角度、ROM改善和GPE无显著差异（p > 0.05）。
测量截骨方法是一种可靠的方法，可协助外科医生在MB-UKA中选择理想的半月板承重厚度，以实现合适的间隙平衡并获得更好的临床结果。
ClinicalTrials.gov（NCT03815448）。
