固定与活动平台单髁置换术的近期结果比较（开放获取）

Short-term outcomes of fixed-bearing unicompartmental knee arthroplasty versus mobile bearing counterpart for medialknee osteoarthritis

摘要:

[目的] 比较固定平台单髁置换（fixed-bearing unicompartmental knee arthroplasty, FB-UKA） 与活动平台单髁置换（mobile-bearing unicompartmental knee arthroplasty, MB-UKA） 治疗膝关节内侧间室骨关节炎的临床疗效。[方法] 回顾性分析2020 年1 月—2023 年2 月采用UKA 治疗的98 例膝关节内侧间室骨关节炎患者的临床资料。根据医患沟通结果，43 例采用FB-UKA，使用Zimmer 假体；另外55 例采用MB-UKA，使用Oxford 假体。比较两组围手术期、随访及影像结果。[结果] 所有患者均顺利完成手术，两组手术时间、切口长度、术中失血量、下地行走时间、切口愈合等级、住院时间、治疗费用的差异均无统计学意义（P＞0.05）。随访时间平均（12.7±4.8） 个月。两组完全负重活动时间的差异无统计学意义（P＞0.05），术后两组患者VAS、WOMAC 评分均显著减少（P＜0.05），HSS、FJS 评分及膝伸-屈ROM 均显著增加（P＜0.05）。末次随访时，MB 组的关节遗忘评分（forgotten joint score, FJS） [(85.5±3.5) vs (84.1±2.7), P=0.032]、膝伸-屈ROM [(125.4±3.5)° vs (123.7±4.2)°, P=0.031] 显著优于FB 组。影像方面，术后两组HKAA、JICA 均显著改善（P＜0.05），TPVA 无显著变化（P＞0.05）。相应时间点，两组间上述影像指标的差异均无统计学意义（P＞0.05）。[结论] 对于内侧室膝骨性关节炎，MB-UKA 术后近期关节遗忘评分优于FB-UKA。

Abstract:

[Objective] To compare the short-term clinical outcomes of fixed-bearing unicompartmental knee arthroplasty (FB-UKA)verus mobile bearing unicompartmental knee arthroplasty (MB-UKA) for medial knee osteoarthritis. [Methods] A retrospective study wasconducted on 98 patients who received UKA for medial knee osteoarthritis from January 2020 to February 2023. According to the results ofdoctor-patient communication, 43 underwent FB-UKA with Zimmer prosthesis, while other 55 patients were treated with MB-UKA by usingOxford prosthesis. The data of perioperative period, follow-up and images were compared between the two groups. [Results] All patients inboth groups had UKA performed successfully without statistically significant differences in operation time, incision length, intraoperativeblood loss, ambulation time, incision healing grade, hospital stay and hospital cost between the two groups (P＞0.05). All of them in bothgroups were followed up for (12.7±4.8) months in an average, and there was no significant difference in the time to regain full weight-bearingactivities between the two groups (P＞0.05). The VAS and WOMAC scores significantly decreased (P＜0.05), while HSS score, forgotten jointscore (FJS) and knee extension-flexion ROM significantly increased in both groups at the latest follow-up compared with those preoperative-ly (P＜0.05). At the last follow-up, the MB group was significantly better than the FB group in terms of FJS [(85.5±3.5) vs (84.1±2.7), P=0.032], and knee extension-flexion ROM [(125.4±3.5)° vs (123.7±4.2)°, P=0.031]. As for imaging, HKAA and JICA were significantly im-proved in both groups after surgery (P＜0.05), while TPVA remained unchanged significantly (P＞0.05). At corresponding time points, therewere no significant differences in the above imaging items between the two groups (P＞0.05). [Conclusion] For medial knee osteoarthritis,the MB-UKA has better forgotten joint score regarding to short-term clinical consequence over the FB-UKA.