Long-term results of lateral unicompartmental knee arthroplasty with a mobile-bearing device.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2025-03-01 DOI:10.1302/0301-620X.107B3.BJJ-2024-0859.R1

Tilman Walker, Julius Freericks, Paul Mick, Raphael Trefzer, Andre Lunz, Kevin-Arno Koch, Tobias Renkawitz, Mustafa Hariri

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引用次数: 0

Abstract

Aims: Unicompartmental knee arthroplasty (UKA) is one option in the treatment of isolated unicompartmental advanced osteoarthritis (OA). While long-term results exist for medial mobile-bearing (MB) UKA, evidence regarding lateral MB-UKA is still limited. The Oxford Domed Lateral (ODL) implant aims to reduce the bearing dislocation rate in lateral MB-UKA through enhanced bearing entrapment. However, the long-term performance of this implant remains unclear. This study evaluated the long-term survival and clinical outcomes of the ODL in a non-designer centre.

Methods: This single-centre retrospective analysis included 115 lateral MB-UKAs using the ODL performed between January 2006 and December 2014. The primary endpoint of the study was implant survival, defined as the time until a revision procedure was required for any reason. Secondary outcomes included Oxford Knee Score (OKS), Forgotten Joint Score (FJS), pain, satisfaction, and Tegner Activity Scale (TAS). Survival was assessed using Kaplan-Meier analysis.

Results: At ten years, the cumulative implant survival rate was 74.8% (95% CI 65.2 to 82.1; number at risk = 71), with bearing dislocation (8.5%) and OA progression (10.4%) as leading revision causes. In 55 non-revised knees with a mean follow-up of 13.4 years (SD 1.8), the mean postoperative OKS improved significantly to 37.8 (SD 9.1) (p < 0.001). Additionally, 85.5% of patients (n = 47) reported satisfaction, with a mean FJS of 65.9 (SD 32.2) and TAS of 2.8 (SD 1.1). However, only 76.4% (n = 42) attained the patient-acceptable symptom state for OKS and FJS.

Conclusion: This is the first long-term ODL study from a non-designer centre; our results demonstrated high failure rates due to bearing dislocation and OA progression, despite satisfactory clinical outcomes in non-revised patients. The disproportionately high risk of failure suggests that the MB design should be abandoned in favour of a fixed-bearing device for lateral UKA.

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使用移动支承装置进行外侧单室膝关节置换术的长期效果。

目的：单室膝关节置换术（UKA）是治疗孤立性单室晚期骨关节炎（OA）的一种选择。虽然对于内侧移动轴承（MB） UKA的长期结果已经存在，但关于外侧MB-UKA的证据仍然有限。Oxford dome Lateral （ODL）种植体旨在通过增强轴承夹持来降低侧位MB-UKA的轴承脱位率。然而，这种植入物的长期性能仍不清楚。本研究在非设计中心评估了ODL的长期生存和临床结果。方法：该单中心回顾性分析包括2006年1月至2014年12月期间使用ODL进行的115例侧向MB-UKAs。研究的主要终点是种植体存活，定义为任何原因需要翻修手术之前的时间。次要结果包括牛津膝关节评分（OKS）、遗忘关节评分（FJS）、疼痛、满意度和Tegner活动量表（TAS）。生存率采用Kaplan-Meier分析。结果：10年累积种植体存活率为74.8% (95% CI 65.2 ~ 82.1；有风险的人数= 71)，其中轴承脱位（8.5%）和OA进展（10.4%）是主要的翻修原因。在55例未翻修的膝关节中，平均随访13.4年（SD 1.8），术后平均OKS显著提高至37.8 (SD 9.1) （p < 0.001）。此外，85.5%的患者（n = 47）表示满意，平均FJS为65.9 (SD 32.2)， TAS为2.8 （SD 1.1）。然而，只有76.4% （n = 42）的患者达到了OKS和FJS患者可接受的症状状态。结论：这是第一个来自非设计中心的长期ODL研究；我们的研究结果显示，尽管未翻修患者的临床结果令人满意，但由于轴承脱位和OA进展导致的失败率很高。不成比例的高失败风险表明，对于横向UKA，应放弃MB设计，转而采用固定轴承装置。

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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