Wear patterns of compartments in varus knee osteoarthritis among an asian population: A cross-sectional study with radiographic and intraoperative analysis.

IF 2.6 3区 医学 Q2 ORTHOPEDICS
International Orthopaedics Pub Date : 2025-08-01 Epub Date: 2025-04-29 DOI:10.1007/s00264-025-06549-6
Kwong Weng Loh, Khairul Anwar Ayob, Fahrudin Che-Hamzah, Azhar Mahmood Merican, Shahrul Hisham Sulaiman, Joo Ann Lee, Sei Kern Tiew
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引用次数: 0

Abstract

Purpose: Osteoarthritis (OA) of the knee significantly impairs mobility and quality of life. Knee arthroplasties have dramatically improved patient outcomes, allowing individuals to regain independence. Unicompartmental knee arthroplasty (UKA) is a surgical option for patients with isolated single-compartment disease, offering the benefits of reduced surgical time and minimized surgical risks. However, the appropriateness of UKA is often underestimated. Therefore, this study aims to determine the proportion of patients with varus knee OA who are suitable candidates for UKA.

Methods: A prospective cross-sectional study was conducted on 207 knees undergoing knee arthroplasty surgery for varus knee OA. Pre-operative radiographs were graded using both the Kellgren-Lawrence (KL) and modified Keyes classifications. Intra-operatively, the knees were inspected, and photographs of the tibial cut were reviewed by a neutral observer. The appropriateness of UKA was determined based on these evaluations.

Results: The lateral compartment was not involved in 169 (81.6%) knees. Only six (2.9%) knees had a KL grade 4 involvement of the lateral compartment. After excluding patients with isolated medial compartment OA, no radiographic evidence of lateral and patellofemoral involvement, and a grade 1 on the modified Keyes classification, we found that 79 (38.2%) patients were suitable candidates for a medial UKA. Intraoperatively, 84 (40.6%) patients had a functional ACL with no observable wear in the lateral and patellofemoral joint (PFJ) compartments.

Conclusion: In patients with varus knee OA, a significant proportion have wear patterns suitable for management with a UKA. Identifying these patients requires targeted examinations and specific radiographic views.

亚洲人群中膝内翻骨性关节炎的腔室磨损模式:一项包含x线摄影和术中分析的横断面研究。
目的:膝关节骨关节炎(OA)严重损害活动能力和生活质量。膝关节置换术极大地改善了患者的预后,使患者能够重新获得独立。单室膝关节置换术(UKA)是孤立性单室疾病患者的一种手术选择,可减少手术时间和降低手术风险。然而,UKA的适当性经常被低估。因此,本研究旨在确定膝内翻OA患者适合UKA的比例。方法:对207例膝关节内翻性膝关节炎行膝关节置换术的膝关节进行前瞻性横断面研究。术前x线片采用Kellgren-Lawrence (KL)分级和改良的Keyes分级。术中,膝关节被检查,胫骨切口的照片由中立的观察者审查。UKA的适当性是根据这些评价确定的。结果:169例(81.6%)膝关节外侧腔室未受累。只有6个(2.9%)膝关节有KL 4级累及外侧腔室。在排除孤立性内侧腔室骨关节炎、无外侧和髌骨受累的影像学证据、改良的Keyes分级为1级的患者后,我们发现79例(38.2%)患者适合内侧腔室骨关节炎。术中,84例(40.6%)患者ACL功能正常,外侧和髌股关节(PFJ)间室无明显磨损。结论:在膝内翻OA患者中,有相当比例的患者有适合UKA治疗的磨损模式。识别这些患者需要有针对性的检查和特定的x线片。
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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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