无骨水泥单室膝关节置换术在4.2年的随访中是安全有效的：一项系统综述

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-05-07 DOI:10.1002/jeo2.70253

Pierangelo Za, Giuseppe Francesco Papalia, Umberto Cardile, Pietro Gregori, Sebastiano Vasta, Edoardo Franceschetti, Stefano Campi, Rocco Papalia

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引用次数: 0

摘要

目的骨水泥单室膝关节置换术（UKA）是一种广泛应用于治疗膝前内侧和外侧骨关节炎的方法。然而，无骨水泥UKA有几个优点，如改善骨整合，减少骨水泥相关费用和并发症。本研究的目的是分析无骨水泥UKA的临床结果、生存率、并发症、失败率和翻修率。方法于2024年5月31日在PubMed、Cochrane Library和Scopus上进行系统综述。我们纳入了随机临床试验、前瞻性和回顾性研究，报告了无水泥UKA的临床结果、种植体存活、并发症、失败和翻修率。提取以下数据：研究设计、植入物类型、患者和膝关节数量、随访、年龄、性别、术前和术后临床结果、再手术和翻修手术失败原因和总生存期。结果纳入15项研究，涉及3475例患者和3641例UKA（非骨水泥UKA 2568例，骨水泥UKA 854例）。患者平均年龄为66岁。平均随访时间为6.5年。无骨水泥UKA的牛津膝关节评分从术前的17.8分提高到术后的40.3分。无骨水泥UKA患者的膝关节社会评分从术前的118.2分提高到术后的168.6分。无水泥UKA的再手术率为3.85%，水泥UKA的再手术率为9%。最常见的翻修原因是骨关节炎进展（1.4%）、无菌性松动（0.8%）、轴承脱位和不明原因的疼痛（0.7%）。无骨水泥UKA的5年和10年总生存率分别为96.2%和93.6%。结论：无骨水泥UKA是骨水泥UKA的可行替代方案，失败率低，至少随访4.2年，临床获益不低。证据等级III级，系统评价研究。

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Cementless unicompartmental knee arthroplasty is safe and effective at a minimum follow-up of 4.2 years: A systematic review

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Cementless unicompartmental knee arthroplasty is safe and effective at a minimum follow-up of 4.2 years: A systematic review

Purpose

Cemented unicompartmental knee arthroplasty (UKA) is a widely used procedure in the treatment of anteromedial and lateral knee osteoarthritis. However, several advantages are reported for cementless UKA, such as improved osseointegration, reduced cement-related costs and complications. The aim of this study was to analyse clinical outcomes, survival, complications, failures and revision rate of cementless UKA.

Methods

A systematic review was performed on 31 May 2024, on PubMed, Cochrane Library and Scopus. We included randomised clinical trials and prospective and retrospective studies reporting clinical outcomes, implant survival, complications, failures and revision rates of cementless UKA. The following data were extracted: study design, type of implant, number of patients and knees, follow-up, age, sex, pre-operative and post-operative clinical outcomes, reoperations and revisions with causes of failure and overall survival.

Results

Fifteen studies were included, involving 3475 patients and 3641 UKA (2568 cementless UKA and 854 cemented UKA). The mean patients' age was 66 years. The mean follow-up was 6.5 years. The Oxford Knee Score improved from 17.8 preoperatively to 40.3 post-operatively in cementless UKA. Knee Society Score improved from 118.2 preoperatively to 168.6 post-operatively in cementless UKA. The reoperation rate was 3.85% for cementless UKA and 9% for cemented UKA. The most common causes of revision were osteoarthritis progression (1.4%), aseptic loosening (0.8%), bearing dislocation and unexplained pain (0.7%). The overall survival of cementless UKA was 96.2% and 93.6% at 5 and 10 years, respectively.

Conclusion

Cementless UKA is a viable alternative to cemented UKAs with a low failure rate, without a lower clinical benefit at a minimum follow-up of 4.2 years.