Cemented medial mobile-bearing Unicompartmental Knee Arthroplasty: Effects of compliance with current indications on functional outcomes and long-term survival rates

Q4 Medicine
Luis Bernal-Fortich MD , Andrés Correa-Valderrama MD , Andres Echeverry-Vélez MD , Willy Stangl-Herrera MD , Erika Cantor MSc , Mónica Morales MSc , Julio César Palacio-Villegas
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引用次数: 0

Abstract

Background

Unicompartmental knee arthroplasty (UKA) is a surgical option for patients with medial compartment osteoarthritis (OA). The objective of this study was to describe the functional outcomes and long-term survival rates of cemented medial mobile-bearing UKA according to the compliance with current indications.

Methods

Retrospective study of 78 patients with medial unicompartimental knee OA treated with mobile-bearing cemented UKA (Oxford phase-III) between 2002 and 2012, with an average follow-up of 10.4 ± 3.4 years. Preoperative radiographs and clinical records were reviewed to assess the compliance with current indications (isolated medial compartment OA, flexion ≥ 90°, integrity of all ligaments, varus deformity<15°). Patients who met all criteria were classified with appropriate indication. The function was measured using the knee society score (KSS).

Results

Nineteen (24.3%) patients did not meet the current indications for UKA. Non-isolated OA of the medial compartment was the most frequent inappropriate indication (16 patients), followed by range of flexion<90° (2 patients) and lack of integrity of the ligaments (1 patient). A significant improvement was found on the KSS after surgery [preoperative KSS: 50.0 (Interquartile range-IQR: (35.0–60.0); postoperative KSS: 70.0 (IQR:60.0–70.0), p < 0.05]. Survival after 15 years of follow-up in cases without and with appropriate indication was 55.8% and 89.7%, respectively. A higher risk of revision surgery was found in cases with inappropriate indication (hazard ratio: 4.87, 95% Confidence Interval: 1.54–15.38, p:0.007).

Conclusion

When proper patient selection is carried out, cemented medial mobile-bearing UKA offers good functional outcomes with a survival rate of 89.7% at 15 years of follow-up.

骨水泥内侧可移动单室膝关节置换术:符合当前适应症对功能结局和长期生存率的影响
背景:内腔室膝关节置换术(UKA)是治疗内侧腔室骨关节炎(OA)患者的一种手术选择。本研究的目的是根据当前适应症的依从性描述骨水泥内固定移动承重UKA的功能结局和长期生存率。方法回顾性研究2002 - 2012年间78例使用活动轴承骨水泥UKA治疗的单侧膝关节OA患者(Oxford iii期),平均随访时间10.4±3.4年。回顾术前x线片和临床记录,以评估当前适应症的依从性(孤立的内侧腔室OA,屈曲≥90°,所有韧带完整,内翻变形15°)。符合所有标准的患者进行适当的适应证分类。使用膝关节社会评分(KSS)测量功能。结果19例(24.3%)患者不符合目前UKA的适应症。非孤立性内侧筋膜室骨关节炎是最常见的不适当适应症(16例),其次是屈曲范围90°(2例)和韧带缺乏完整性(1例)。术后KSS有明显改善[术前KSS: 50.0(四分位数间距- iqr: 35.0-60.0);术后KSS: 70.0 (IQR:60.0 ~ 70.0), p <0.05]。15年随访后,无适应证和有适应证患者的生存率分别为55.8%和89.7%。适应症不合适的患者翻修手术的风险更高(风险比:4.87,95%可信区间:1.54 ~ 15.38,p:0.007)。结论当患者选择正确时,15年随访时,骨水泥移动承重UKA具有良好的功能预后,生存率为89.7%。
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
Journal of Arthroscopy and Joint Surgery
Journal of Arthroscopy and Joint Surgery Medicine-Orthopedics and Sports Medicine
CiteScore
0.60
自引率
0.00%
发文量
1
期刊介绍: Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.
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