Rajani Amyn M, Mittal Anmol Rs, Shah Urvil A, Kulkarni Vishal U, Dubey Rishab
Department of Orthopaedics, OAKS Clinic, 707 Panchshil Plaza, N S Patkar Marg, Gamdevi, Mumbai, Maharashtra, 400007, India.
J Clin Orthop Trauma. 2025 Jun 27;68:103115. doi: 10.1016/j.jcot.2025.103115. eCollection 2025 Sep.
Isolated anteromedial osteoarthritis (AMOA) is prevalent in 46.94 % of the Indian population undergoing primary total knee arthroplasty (TKA). Compared with TKA, medial unicompartmental knee arthroplasty (UKA) has shown superior functional outcomes in such patients but remains underutilised in India. This study aimed to assess the midterm functional and clinical outcomes, long-term survival, and complications of cemented Oxford UKA in Indian patients with isolated AMOA and to analyse the factors influencing its acceptance and success.
This prospective, observational study was conducted at a single center from September 2014 to September 2024 and included 191 knees from 180 patients. Preoperative and follow-up assessments included clinical and patient-reported outcome measures (PROMs), such as the American Knee Society (KSS), the Oxford Knee Score (OKS), and the forgotten joint score (FJS). The complication and revision rates were also monitored.
Significant improvement in all PROMs and clinical outcomes was observed at 5 years post-surgery. The mean preoperative KSS improved from 48.2 to 88.3, the mean OKS improved from 28.7 to 40.5, the mean FJS improved from 38.1 to 73.6, and the mean ROM improved from 91.5° to 120.4° at 5 years post-surgery (p < 0.001). Majority patients could squat, sit on the floor, and sit cross-legged within one-year post-surgery. The 5-year survivorship was 96.85 %. Six knees required revision surgery, with progression of osteoarthritis to the lateral compartment being the most common cause. The frequency of complications was inversely related to surgeon experience and case volume.
Cemented Oxford UKA yields excellent clinical and functional outcomes for Indian patients with isolated AMOA, with 96.85 % 5-year survival and significant improvements in PROMs and range of motion. The procedure enables patients to resume traditional activities requiring a high range of motion. Enhanced patient and surgeon education is needed to increase the acceptance of UKA in India.
在接受初次全膝关节置换术（TKA）的印度人群中，孤立性前内侧骨关节炎（AMOA）的患病率为46.94%。与TKA相比，内侧单髁膝关节置换术（UKA）在这类患者中显示出更好的功能结局，但在印度的应用率仍然较低。本研究旨在评估骨水泥固定牛津UKA治疗孤立性AMOA的印度患者的中期功能和临床结局、长期生存率及并发症，并分析影响其接受度和成功率的因素。
本前瞻性观察性研究于2014年9月至2024年9月在单一中心进行，纳入180例患者的191个膝关节。术前和随访评估包括临床及患者报告的结局指标（PROMs），如美国膝关节协会（KSS）评分、牛津膝关节评分（OKS）和遗忘关节评分（FJS）。同时监测并发症及翻修率。
术后5年时，所有PROMs和临床结局均有显著改善。术后5年时，术前KSS评分均值从48.2提高到88.3，OKS评分均值从28.7提高到40.5，FJS评分均值从38.1提高到73.6，ROM均值从91.5°提高到120.4°（p<0.001）。大多数患者在术后1年内能够下蹲、坐在地上和盘腿而坐。5年生存率为96.85%。6个膝关节需要翻修手术，最常见的原因是骨关节炎进展至外侧间室。并发症的发生率与外科医生的经验和病例数量呈负相关。
骨水泥固定牛津UKA治疗孤立性AMOA的印度患者可产生优异的临床和功能结局，5年生存率为96.85%，PROMs和活动范围有显著改善。该手术使患者能够恢复需要较大活动范围的传统活动。需要加强患者和外科医生教育，以提高UKA在印度的接受度。
