Outcomes of fixed versus mobile-bearing medial unicompartmental knee arthroplasty.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2024-09-01 DOI:10.1302/0301-620X.106B9.BJJ-2024-0075.R1

Kevin B Fricka, Eric J Wilson, Alexander V Strait, Henry Ho, Robert H Hopper, William G Hamilton, Robert A Sershon

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引用次数: 0

Abstract

Aims: The optimal bearing surface design for medial unicompartmental knee arthroplasty (UKA) remains controversial. The aim of this study was to compare outcomes of fixed-bearing (FB) and mobile-bearing (MB) UKAs from a single high-volume institution.

Methods: Prospectively collected data were reviewed for all primary cemented medial UKAs performed by seven surgeons from January 2006 to December 2022. A total of 2,999 UKAs were identified, including 2,315 FB and 684 MB cases. The primary outcome measure was implant survival. Secondary outcomes included 90-day and cumulative complications, reoperations, component revisions, conversion arthroplasties, range of motion, and patient-reported outcome measures. Overall mean age at surgery was 65.7 years (32.9 to 94.3), 53.1% (1,593/2,999) of UKAs were implanted in female patients, and demographics between groups were similar (p > 0.05). The mean follow-up for all UKAs was 3.7 years (0.0 to 15.6).

Results: Using revision for any reason as an endpoint, five-year survival for FB UKAs was 97.2% (95% CI 96.4 to 98.1) compared to 96.0% for MB (95% CI 94.1 to 97.9; p = 0.008). The FB group experienced fewer component revisions (14/2,315, 0.6% vs 12/684, 1.8%; p < 0.001) and conversion arthroplasties (38/2315, 1.6% vs 24/684, 3.5%; p < 0.001). A greater number of MB UKAs underwent revision due to osteoarthritis progression (FB = 21/2,315, 0.9% vs MB = 16/684, 2.3%; p = 0.003). In the MB group, 12 (1.8%) subjects experienced bearing dislocations which required revision surgery. There were 15 early periprosthetic tibia fractures (0.6%) in the FB group compared to 0 for MB (p = 0.035).

Conclusion: In similar patient populations, FB UKAs demonstrated slightly higher survival than a commonly used MB design. Adverse event profiles differed by bearing type, with an increased risk of bearing dislocation and OA progression with MB designs, and early periprosthetic tibia fractures for FB designs.

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固定式与移动式内侧单室膝关节置换术的疗效对比。

目的：内侧单室膝关节置换术（UKA）的最佳承力面设计仍存在争议。本研究的目的是比较来自一家高产量机构的固定支座（FB）和移动支座（MB）UKA 的疗效：研究回顾了2006年1月至2022年12月期间由七位外科医生实施的所有初次骨水泥内侧UKA的前瞻性数据。共确定了2999例UKA，包括2315例FB和684例MB。主要结果指标是植入物存活率。次要结果包括 90 天并发症和累积并发症、再次手术、组件翻修、转换关节置换、活动范围以及患者报告的结果指标。手术时的总平均年龄为65.7岁（32.9至94.3岁），53.1%（1,593/2,999）的UKA植入女性患者体内，各组间的人口统计学特征相似（P>0.05）。所有UKA的平均随访时间为3.7年（0.0至15.6年）：结果：以任何原因的翻修为终点，FB UKAs 的五年生存率为 97.2% (95% CI 96.4 to 98.1)，而 MB 为 96.0% (95% CI 94.1 to 97.9; p = 0.008)。FB组经历的组件翻修（14/2315，0.6% vs 12/684，1.8%；p < 0.001）和转换关节成形术（38/2315，1.6% vs 24/684，3.5%；p < 0.001）更少。更多的 MB UKA 因骨关节炎进展而进行了翻修（FB = 21/2,315, 0.9% vs MB = 16/684, 2.3%; p = 0.003）。在 MB 组中，有 12 名受试者（1.8%）出现轴承脱位，需要进行翻修手术。FB组有15例早期假体周围胫骨骨折（0.6%），而MB组为0例（P = 0.035）：结论：在相似的患者群体中，FB UKAs的存活率略高于常用的MB设计。支座类型不同，不良事件也不同，MB 设计的支座脱位和 OA 进展风险增加，FB 设计的早期假体周围胫骨骨折风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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