Yang Tao, Xue Huaming, Ma Tong, Wen Tao, Xue Long, Tu Yihui
Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China.
J Orthop Surg Res. 2025 Mar 14;20(1):284. doi: 10.1186/s13018-025-05615-4.
Meniscectomy is a common knee surgery for meniscal tear, and is associated with progressive osteoarthritis (OA). There are few literatures focus on the use of lateral unicompartmental knee arthroplasty (UKA) for lateral post-meniscectomy knee osteoarthritis (PMKO). Therefore, the purpose of this study is to compare the outcomes of lateral UKA performed for lateral PMKO and primary lateral compartment knee osteoarthritis (LCKO).
A total of 38 consecutive patients (38 knees) who received lateral UKAs for isolated lateral PMKO between September 2013 and September 2019 were retrospectively analyzed. Other thirty-eight patients (38 knees) with primary LCKO were allocated into control group by 1:1 matching according to age, gender, and body mass index. The clinical outcomes were evaluated using the American Knee Society Score, range of motion, Forgotten Joint Score, and EuroQol-5D (EQ-5D) Score. The radiographic assessments included hip-knee-ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and posterior tibial slope angle (PTSA).
With a mean 7 years follow-up, there was no significant difference in functional and radiographic outcomes between groups. However, the PMKO group showed severe lateral OA (p = 0.02) preoperatively and less OA progression in the medial compartment postoperatively (p = 0.046). The preoperative mLDFA was significantly more valgus in the LCKO group (p < 0.001). No case of revision occurred in either group.
Lateral UKA is a valid procedure for lateral PMKO. The clinical and radiographic results are similar in patients underwent lateral UKA for lateral PMKO and for LCKO. Patients with lateral PMKO exhibited severe lateral OA preoperatively and less OA progression in the medial compartment compared to those with LCKO. It is crucial to prevent ascension of the lateral femoral joint-line and maintain proper valgus alignment during lateral UKA.
半月板切除术是治疗半月板撕裂的常见膝关节手术，且与进行性骨关节炎（OA）相关。很少有文献关注外侧单髁膝关节置换术（UKA）用于外侧半月板切除术后膝关节骨关节炎（PMKO）的情况。因此，本研究的目的是比较外侧UKA治疗外侧PMKO与原发性外侧间室膝关节骨关节炎（LCKO）的疗效。
回顾性分析2013年9月至2019年9月期间连续接受外侧UKA治疗孤立性外侧PMKO的38例患者（38膝）。另外38例原发性LCKO患者根据年龄、性别和体重指数按1:1匹配分配到对照组。使用美国膝关节协会评分、活动范围、遗忘关节评分和欧洲五维健康量表（EQ-5D）评分评估临床疗效。影像学评估包括髋-膝-踝（HKA）角、机械性外侧股骨远端角（mLDFA）、机械性内侧胫骨近端角（mMPTA）和胫骨后倾角（PTSA）。
平均随访7年，两组之间的功能和影像学结果无显著差异。然而，PMKO组术前外侧OA严重（p = 0.02），术后内侧间室OA进展较少（p = 0.046）。LCKO组术前mLDFA外翻明显更严重（p < 0.001）。两组均未发生翻修病例。
外侧UKA是治疗外侧PMKO的有效方法。外侧UKA治疗外侧PMKO和LCKO的临床和影像学结果相似。与LCKO患者相比，外侧PMKO患者术前外侧OA严重，内侧间室OA进展较少。在外侧UKA期间，防止外侧股骨关节线上升并保持适当的外翻对线至关重要。
