Fixed lateral unicompartmental knee replacement is a reliable treatment for lateral compartment osteoarthritis after mobile-bearing medial unicompartmental replacement,Knee Surgery, Sports Traumatology, Arthroscopy

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Fixed lateral unicompartmental knee replacement is a reliable treatment for lateral compartment osteoarthritis after mobile-bearing medial unicompartmental replacement
Knee Surgery, Sports Traumatology, Arthroscopy ( IF 3.3 ) Pub Date : 2023-09-28 , DOI: 10.1007/s00167-023-07573-y
Joseph T Lazzara ₁ , Lachlan W Arthur ₁ , Cathy Jenkins ₂ , Christopher A F Dodd ₂ , Stephen J Mellon ₁ , David W Murray _{1,

2}

Affiliation

Purpose

Lateral osteoarthritis following medial unicompartmental knee replacement (UKR) is usually treated with total knee replacement, however, lateral UKR is a less invasive option that preserves a well-functioning medial UKR. This study aimed to determine the 5-year outcome of the cemented Fixed Lateral Oxford UKR (FLO) when used for the treatment of severe lateral disease after medial Oxford unicompartmental knee replacement.

Methods

Forty-four knees with lateral bone-on-bone osteoarthritis (n = 43) and avascular necrosis (n = 1) treated with the FLO following medial Oxford UKR were followed up prospectively. The Oxford Knee Score (OKS) and Tegner Activity Score (TAS) were collected pre- and post-operatively. Life-table analysis was used to determine survival rates.

Results

The mean patient age at the time of FLO surgery was 74.4 years with a mean time of 12.1 years between the primary medial UKR and the conversion to a bi-UKR with a FLO. Mean follow-up of the FLO was 3.5 years. After FLO no intra-operative or medical complications, re-admissions, or mortality occurred. There was one reoperation in which a bearing was exchanged for a medial bearing dislocation. There were no revisions of the FLO, so the FLO survival rate at 5 years was 100% (24 at risk). The mean pre-operative OKS was 22, which significantly (p < 0.0001) improved to a mean of 42, 42, and 40 at 1, 2, and 5 years, respectively. The median TAS had a non-significant improvement from 2.5 (Range 0–8) pre-operatively to 2 (Range 1–6) at 5 years postoperatively.

Conclusion

The FLO is a reliable treatment for lateral osteoarthritis following medial UKR. At 5 years there was a 100% survival of the FLO with a mean OKS of 40.

Level of evidence

IV, Prospective Case Series.

中文翻译：

固定外侧单间室膝关节置换术是移动轴承内侧单间室置换术后外侧间室骨关节炎的可靠治疗方法

目的

内侧单间室膝关节置换术 (UKR) 后的外侧骨关节炎通常采用全膝关节置换术治疗，然而，外侧 UKR 是一种侵入性较小的选择，可以保留功能良好的内侧 UKR。本研究旨在确定骨水泥固定外侧牛津 UKR (FLO) 在用于治疗内侧牛津单间室膝关节置换术后严重外侧疾病时的 5 年结果。

方法

对 44 名患有外侧骨对骨骨关节炎 ( n = 43) 和缺血性坏死 ( n = 1) 的膝关节进行前瞻性随访，这些膝关节在内侧 Oxford UKR 后接受 FLO 治疗。术前和术后收集牛津膝关节评分（OKS）和 Tegner 活动评分（TAS）。生命表分析用于确定生存率。

结果

FLO 手术时患者的平均年龄为 74.4 岁，从初次内侧 UKR 到转换为带有 FLO 的双 UKR 之间的平均时间为 12.1 年。 FLO 的平均随访时间为 3.5 年。 FLO 后，没有发生术中或医疗并发症、再次入院或死亡。有一次再次手术，其中轴承因内侧轴承脱位而被更换。由于没有对 FLO 进行修订，因此 5 年 FLO 存活率为 100%（24 人处于危险之中）。术前平均 OKS 为 22，在 1 年、2 年和 5 年分别显着改善 ( p < 0.0001)，平均为 42、42 和 40。术后 5 年，中位 TAS 从术前的 2.5（范围 0-8）提高到 2（范围 1-6），无显着改善。