牛津单髁膝关节置换术中的骨折与股骨部件的内侧定位相关——一项回顾性队列研究。
Fractures in Oxford unicompartmental knee arthroplasty are associated with medial positioning of the femoral component - A retrospective cohort study.
作者信息
Watrinet Julius, Berger Daniel, Blum Philipp, Reidler Paul, Arnholdt Joerg, Siebenlist Sebastian, Schipp Rolf, Reng Wolfgang, Fabritius Matthias P
机构信息
Department of Orthopaedic Sports Medicine, Technical University Munich, Germany, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany; Klinikum Garmisch-Partenkirchen, Endogap, Joint Replacement Institute, Auenstraße 6, 82467 Garmisch-Partenkirchen, Germany.
Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
出版信息
Knee. 2025 Aug;55:70-78. doi: 10.1016/j.knee.2025.04.007. Epub 2025 Apr 22.
UNLABELLED
A.
PURPOSE
This study aimed to evaluate the relationship between femoral component positioning and the incidence of periprosthetic fractures in Oxford unicompartmental knee arthroplasty (UKA), as well as the effects of component size and preoperative coronal lower limb alignment on fracture risk. B.
METHODS
A retrospective single-center study was conducted, including 1,642 cases of medial UKA performed between July 2015 and December 2022. Patients with symptomatic isolated medial knee osteoarthritis meeting specific selection criteria underwent surgery using either press-fit or cemented fixation based on individual bone quality. Radiographic evaluations were performed preoperatively and postoperatively to assess component positioning and alignment. Statistical analyses included the Mann-Whitney U test, Wilcoxon test, and Pearson's chi-squared test to compare fracture and non-fracture groups. C.
RESULTS
Out of 1,642 cases, 15 (0.9%) experienced a tibial periprosthetic fracture. These fractures were significantly associated with medial positioning of the femoral component and smaller component sizes. The fracture group had a higher mean age (74.3 ± 6.2 years) and a higher percentage of females (80%) compared to the non-fracture group. No significant differences were observed in Body Mass Index (BMI) or preoperative coronal alignment between the groups. D.
CONCLUSION
Medial positioning of the femoral component and smaller component sizes in Oxford UKA are associated with an increased risk of tibial periprosthetic fractures. Accurate implant positioning is crucial to minimize fracture risk and improve clinical outcomes. These findings underscore the importance of precise surgical techniques and may inform future guidelines for UKA procedures.
TRIAL REGISTRATION
This study was retrospectively registered and ethical approval was waived by the local ethical committee (No. 22-0990KB).
未标注
A.
目的
本研究旨在评估牛津单髁膝关节置换术（UKA）中股骨组件位置与假体周围骨折发生率之间的关系，以及组件大小和术前冠状位下肢对线对骨折风险的影响。B.
方法
进行了一项回顾性单中心研究，纳入2015年7月至2022年12月期间进行的1642例内侧UKA病例。符合特定选择标准的有症状孤立性内侧膝关节骨关节炎患者根据个体骨质采用压配或骨水泥固定进行手术。术前和术后进行影像学评估以评估组件位置和对线情况。统计分析包括Mann-Whitney U检验、Wilcoxon检验和Pearson卡方检验，以比较骨折组和非骨折组。C.
结果
在1642例病例中，15例（0.9%）发生了胫骨假体周围骨折。这些骨折与股骨组件的内侧位置和较小的组件尺寸显著相关。与非骨折组相比，骨折组的平均年龄更高（74.3±6.2岁），女性比例更高（80%）。两组之间的体重指数（BMI）或术前冠状位对线无显著差异。D.
结论
牛津UKA中股骨组件的内侧位置和较小的组件尺寸与胫骨假体周围骨折风险增加相关。准确的植入物定位对于将骨折风险降至最低并改善临床结果至关重要。这些发现强调了精确手术技术的重要性，并可能为未来UKA手术指南提供参考。
试验注册
本研究为回顾性注册，当地伦理委员会豁免了伦理批准（编号22-0990KB）。
Zotero 插件