日本单室膝关节置换术中影响最小尺寸1胫骨基板置入的因素

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-08-18 DOI:10.1016/j.jor.2025.08.025

Hironao Shioiri , Tsuneari Takahashi , Katsushi Takeshita

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引用次数: 0

摘要

背景：单室膝关节置换术（UKA）中胫骨基板外伸与术后疼痛和功能受损有关。假设：对于日本膝内翻骨性关节炎（KOA）患者，有重要的患者因素影响固定轴承（FB） UKA中1号最小尺寸胫骨底板的植入。目的本研究探讨上述假设因素。方法对2023年3月至2025年7月期间连续74例FB-UKA患者进行回顾性研究。终点为Kellgren和Lawrence （KL）分级；患者身高(m)；体重(公斤);体重指数（BMI, kg/m2）；术前伸展和屈曲活动范围（ROM）；术前髋膝角（HKA）；术前和术后胫骨内侧近端角（MPTA）和胫骨后斜度（PTS）。手术后，用卡尺测量股骨远端、股骨背侧和胫骨近端内侧切除量。记录实际插入的股骨和胫骨假体的大小。进行Logistic回归分析以明确影响1号最小胫骨基板置入的因素。结果单因素分析显示两组患者身高差异有统计学意义（1组1.47±0.1,0组1.57±0.1,P < 0.001）。Logistic回归分析显示，实际插入股骨假体的高度较短（OR: 3.07e-19, 95% CI: 7.54e-35 - 1.25e-03, P = 0.020），股骨假体的尺寸较短（OR: 9.16e-3, 95% CI: 1.48e-4-0.57, P = 0.026）。ROC分析确定患者身高（AUC: 0.872, 95% CI: 0.765-0.980）和2号股骨组成部分（AUC: 0.832, 95% CI: 0.748-0.917）的截断值为1.51 m。结论患者身高和股骨假体大小是影响日本KOA内翻患者FB-UKA内固定1号最小胫骨基板的重要因素。

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Factors influencing the insertion of a size 1 minimum-sized tibial baseplate in fixed-bearing unicompartmental knee arthroplasty for Japanese patients

Background

An overhang of the tibial baseplate in unicompartmental knee arthroplasty (UKA) has been associated with postoperative pain and impaired function.

Hypothesis

There are significant patient factors that influence the insertion of a size 1 minimum-sized tibial baseplate in fixed-bearing (FB) UKA for Japanese patients with varus knee osteoarthritis (KOA).

Purpose

This study investigated the above-hypothesized factors.

Methods

We conducted a retrospective study of 74 consecutive patients who underwent FB-UKA between March 2023 and July 2025. The endpoints were the Kellgren and Lawrence (KL) grade; patient height (m); weight (kg); body mass index (BMI, kg/m²); preoperative extension and flexion range of motion (ROM); preoperative hip–knee angle (HKA); and preoperative and postoperative medial proximal tibial angle (MPTA) and posterior tibial slope (PTS). Following surgery, calipers were used to measure the medial resection amounts of the distal and dorsal femur and the proximal tibia. The sizes of the femoral and tibial components that were actually inserted were recorded. Logistic regression analyses were performed to clarify the factors influencing the insertion of a size 1 minimum-sized tibial baseplate.

Results

Univariate analysis revealed significant difference between the group concerning patient height (1.47 ± 0.1 in Group 1 and 1.57 ± 0.1 in Group O, P < 0.001). Logistic regression demonstrated that shorter height (OR: 3.07e-19, 95 % CI: 7.54e-35– 1.25e-03, P = 0.020), the size of the femoral component that were actually inserted (OR: 9.16e-3, 95 % CI: 1.48e-4-0.57, P = 0.026). ROC analysis identified cutoff values of <1.51 m for patient height (AUC: 0.872, 95 % CI: 0.765–0.980), and size 2 femoral component (AUC: 0.832, 95 % CI: 0.748–0.917).

Conclusion

Patient height and femoral component size were significant factors that influence the insertion of a size 1 minimum-sized tibial baseplate in FB-UKA for Japanese patients with varus KOA.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.