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单髁膝关节置换术的最佳假体:固定型还是活动型?

BEST PROSTHESIS FOR UNICOMPARTMENTAL KNEE ARTHROSIS: FIXED OR MOBILE?

作者信息

Cardoso Fabrício Luz, Gomez Deusimar Cristian Dos Santos, Severino Fabrício Roberto, de Fucs Patrícia Maria Moraes de Barros

机构信息

Santa Casa de Misericórdia de São Paulo, Orthopaedic and Traumatology Department, Pavilhão Fernandinho Simonsen, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2025 Feb 3;33(1):e285052. doi: 10.1590/1413-785220253301e285052. eCollection 2025.

Abstract

This study aimed to compare fixed-bearing and mobile-bearing knee unicompartmental arthroplasty implants in adults (in the medial compartment) to determine which is better for each patient and their particularities. The research focused on postoperative assessments with a follow-up of at least a 2-year, examining both quality of life and mid-term functionality in the medium term. A systematic keyword search was executed in the PubMed, EMBASE, and Cochrane databases, employing a filter for randomized clinical trials and without language limitations. The search yielded 113 articles from March 28, 2024, including 83 from PubMed, 12 from EMBASE, and 18 from the Cochrane Library. The study found insufficient evidence to establish the superiority of one prosthetic type over the other regarding post-operative function, pain, complications, revisions, and quality of life after a 2-year follow-up. Literature highlights uncertainties in comparing UKA types due to varied assessment tools. No conclusive evidence favors either type regarding post-op function, pain, complication rates, revisions, or quality of life after 2 years. Urgent need for standardized, long-term, multicenter studies to inform evidence-based clinical practice.

摘要

本研究旨在比较成人(内侧间室)固定平台和活动平台膝关节单髁置换植入物,以确定哪种植入物对每位患者及其特殊情况更适用。该研究聚焦于术后评估,随访至少2年,考察中期的生活质量和中期功能。在PubMed、EMBASE和Cochrane数据库中进行了系统的关键词搜索,使用随机临床试验过滤器且无语言限制。搜索从2024年3月28日共获得113篇文章,其中83篇来自PubMed,12篇来自EMBASE,18篇来自Cochrane图书馆。研究发现,在2年随访后,关于术后功能、疼痛、并发症、翻修和生活质量方面,没有足够的证据确定一种假体类型优于另一种。文献强调,由于评估工具不同,在比较单髁置换类型时存在不确定性。在术后功能、疼痛、并发症发生率、翻修或2年后的生活质量方面,没有确凿证据支持任何一种类型。迫切需要进行标准化、长期、多中心研究,为循证临床实践提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a993/11801209/441f9bbc3bad/1413-7852-aob-33-01-e285052-gf01.jpg

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