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在短期随访中,与全骨水泥固定相比,混合固定在牛津单髁膝关节置换术中取得了相似或稍好的结果。

Hybrid Fixation Achieves Similar or Slightly Better Results Compared With All Cemented Fixation in Oxford Unicompartmental Knee Arthroplasty at the Short-Term Follow-Up.

作者信息

Saitoh Akira, Hiranaka Takafumi, Okamoto Koji, Fujishiro Takaaki, Koide Motoki, Suda Yoshihito, Tanaka Atsuki, Arimoto Akihiko

机构信息

Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN.

Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, takatsuki, JPN.

出版信息

Cureus. 2025 Mar 31;17(3):e81533. doi: 10.7759/cureus.81533. eCollection 2025 Mar.

DOI:10.7759/cureus.81533
PMID:40314040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12043381/
Abstract

Introduction Cementless Oxford unicompartmental knee arthroplasty (OUKA) has been shown to have less frequent radiolucent lines and equivalent or even better results than those of cemented OUKA. However, tibial fractures are more frequent in cementless OUKA than in cemented OUKA, especially in Asian countries. A hybrid option, with a cementless femur and cemented tibia, may, therefore, be a good compromise. This study compares the clinical results of hybrid OUKA with those of fully cemented OUKA. Materials and methods This retrospective study included 108 consecutive unicompartmental knee arthroplasties implanted between September 2016 and September 2018 in our hospital. Cases were divided into two groups: those using cemented fixation and those using hybrid fixation OUKAs. Pre- and postoperative knee range of motion (ROM), operation time, pre-and postoperative Oxford knee score (OKS), and complications were compared between the groups two years after OUKA was performed. Results There was no significant difference in pre- and postoperative ROM, operation time, and OKS performed unilateral OUKA, but mean OKS was higher in the hybrid group than in the cemented group performed bilateral OUKA (p<0.01). Both groups included one revision to total knee arthroplasty each. There was no statistically significant difference in the rate of revision (p=0.723). Conclusions Better clinical outcomes were achieved in the hybrid fixation group than in the cemented fixation group, with an equivalent rate of complication. Longer follow-up periods are needed to confirm the benefits of hybrid fixation in OUKA over time.

摘要

引言

非骨水泥型牛津单髁膝关节置换术(OUKA)已被证明与骨水泥型OUKA相比,其透亮线出现频率更低,结果相当甚至更好。然而,非骨水泥型OUKA的胫骨骨折发生率高于骨水泥型OUKA,尤其是在亚洲国家。因此,一种股骨非骨水泥、胫骨骨水泥的混合方式可能是一个不错的折衷方案。本研究比较了混合式OUKA与全骨水泥型OUKA的临床结果。

材料与方法

本回顾性研究纳入了2016年9月至2018年9月在我院连续植入的108例单髁膝关节置换术病例。病例分为两组:采用骨水泥固定的和采用混合固定的OUKA。在OUKA术后两年,比较两组术前和术后的膝关节活动范围(ROM)、手术时间、术前和术后牛津膝关节评分(OKS)以及并发症情况。

结果

单侧OUKA术后ROM、手术时间和OKS在两组间无显著差异,但双侧OUKA时混合组的平均OKS高于骨水泥组(p<0.01)。两组各有一例翻修为全膝关节置换术。翻修率无统计学显著差异(p=0.723)。

结论

混合固定组比骨水泥固定组取得了更好的临床效果,并发症发生率相当。需要更长的随访时间来证实混合固定在OUKA中的长期益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/b14a54a15d06/cureus-0017-00000081533-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/fc4a825943cf/cureus-0017-00000081533-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/c402e7cf9c47/cureus-0017-00000081533-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/b14a54a15d06/cureus-0017-00000081533-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/fc4a825943cf/cureus-0017-00000081533-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/c402e7cf9c47/cureus-0017-00000081533-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179e/12043381/b14a54a15d06/cureus-0017-00000081533-i03.jpg

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Hybrid Oxford unicompartmental knee arthroplasty has lower residual cement extrusion than cemented arthroplasty in treating end-stage unicompartmental knee osteoarthritis.混合 Oxford 单间膝关节置换术治疗终末期单间膝关节骨关节炎时,残留的水泥挤出量低于水泥固定型关节置换术。
BMC Musculoskelet Disord. 2021 Sep 29;22(1):833. doi: 10.1186/s12891-021-04720-9.
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Five-year results of a randomised controlled trial comparing cemented and cementless Oxford unicompartmental knee replacement using radiostereometric analysis.
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Tibial shape and size predicts the risk of tibial plateau fracture after cementless unicompartmental knee arthroplasty in Japanese patients.胫骨形态和大小预测日本患者非骨水泥单髁膝关节置换术后胫骨平台骨折的风险。
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Femoral migration of the cementless Oxford which caused the bearing dislocation: a report of two cases.骨水泥型牛津假体股骨迁移导致关节脱位:两例报告。
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