Za Pierangelo, Papalia Giuseppe Francesco, Cardile Umberto, Gregori Pietro, Vasta Sebastiano, Franceschetti Edoardo, Campi Stefano, Papalia Rocco
Department of Orthopaedic and Trauma Surgery Università Campus Bio-Medico di Roma Roma Italy.
Research Unit of Orthopaedic and Trauma Surgery Fondazione Policlinico Universitario Campus Bio-Medico Roma Italy.
J Exp Orthop. 2025 May 7;12(2):e70253. doi: 10.1002/jeo2.70253. eCollection 2025 Apr.
Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.
A systematic review was performed on 31 May 2024, on PubMed, Cochrane Library and Scopus. We included randomised clinical trials and prospective and retrospective studies reporting clinical outcomes, implant survival, complications, failures and revision rates of cementless UKA. The following data were extracted: study design, type of implant, number of patients and knees, follow-up, age, sex, pre-operative and post-operative clinical outcomes, reoperations and revisions with causes of failure and overall survival.
Fifteen studies were included, involving 3475 patients and 3641 UKA (2568 cementless UKA and 854 cemented UKA). The mean patients' age was 66 years. The mean follow-up was 6.5 years. The Oxford Knee Score improved from 17.8 preoperatively to 40.3 post-operatively in cementless UKA. Knee Society Score improved from 118.2 preoperatively to 168.6 post-operatively in cementless UKA. The reoperation rate was 3.85% for cementless UKA and 9% for cemented UKA. The most common causes of revision were osteoarthritis progression (1.4%), aseptic loosening (0.8%), bearing dislocation and unexplained pain (0.7%). The overall survival of cementless UKA was 96.2% and 93.6% at 5 and 10 years, respectively.
Cementless UKA is a viable alternative to cemented UKAs with a low failure rate, without a lower clinical benefit at a minimum follow-up of 4.2 years.
Level III, systematic review of studies.
骨水泥型单髁膝关节置换术（UKA）是治疗膝关节前内侧和外侧骨关节炎的一种广泛应用的手术方法。然而，非骨水泥型UKA具有一些优势，如改善骨整合、降低与骨水泥相关的成本和并发症。本研究的目的是分析非骨水泥型UKA的临床疗效、生存率、并发症、失败情况和翻修率。
于2024年5月31日在PubMed、Cochrane图书馆和Scopus上进行了系统评价。我们纳入了报告非骨水泥型UKA临床疗效、植入物生存率、并发症、失败情况和翻修率的随机临床试验以及前瞻性和回顾性研究。提取了以下数据：研究设计、植入物类型、患者和膝关节数量、随访、年龄、性别、术前和术后临床疗效、再次手术和翻修情况以及失败原因和总体生存率。
纳入15项研究，涉及3475例患者和3641例UKA（2568例非骨水泥型UKA和854例骨水泥型UKA）。患者平均年龄为66岁。平均随访时间为6.5年。非骨水泥型UKA的牛津膝关节评分从术前的17.8提高到术后的40.3。非骨水泥型UKA的膝关节协会评分从术前的118.2提高到术后的168.6。非骨水泥型UKA的再次手术率为3.85%，骨水泥型UKA为9%。最常见的翻修原因是骨关节炎进展（1.4%）、无菌性松动（0.8%）、轴承脱位和不明原因疼痛（0.7%）。非骨水泥型UKA在5年和10年时的总体生存率分别为96.2%和93.6%。
非骨水泥型UKA是骨水泥型UKA的一种可行替代方案，失败率低，在至少4.2年的随访中临床获益不低。
III级，研究的系统评价。
