Unikompartmantal diz artroplastisinin alt ekstremite ekseni, tibiofemoral subluksasyon ve lateral diz eklem mesafesine etkisi

Year 2021, , 699 - 705, 30.06.2021

Hakan Aslan , Evrim Duman , Osman Yağız Atlı , Hüseyin Bilgehan Çevik

https://doi.org/10.17826/cumj.860594

Abstract

Amaç: Bu çalışmanın amacı, Oxford faz 3 medial unikompartmantal diz artroplastisinin (UDA) alt ekstremite ekseni, tibiofemoral subluksasyon ve lateral eklem mesafesi üzerindeki düzeltici etkisini araştırmaktı.
Gereç ve Yöntem: Çalışmaya UDA yapılan 105 diz dahil edildi. Oxford Diz Skoru, EQ-5D-3LD, vizüel analog skalası ve diz yaralanması ve osteoartrit sonuç skorları değerlendirildi. Alt ekstremite aksı, tibiofemoral subluksasyon ve lateral diz eklem mesafesinin radyolojik değerlendirmesi yapıldı.
Bulgular: Preoperatif değerlere göre mekanik eksende postoperatif ortalama düzelme 1.4 ° ve tibiofemoral subluksasyon mesafesinde 1.59 mm idi. Preoperatif ve postoperatif lateral eklem mesafesi değerleri arasındaki fark ortalama 0,25 mm lateral iç eklem mesafesi, lateral orta eklem mesafesinde 0,08 mm ve dış eklem mesafesinde 0,34 mm. Gruplar arasında klinik sonuçlarda anlamlı bir fark yoktu.
Sonuç: Alt ekstremite mekanik aks, tibiofemoral subluksasyon mesafesi ve lateral eklem mesafelerinin ölçümlerinde çimentolu, çimentosuz ve hibrid medial UDA sonrası postoperatif dönemde preoperatif döneme göre anlamlı iyileşmeler vardı.

Keywords

Unikompartmantal, diz artroplastisi, tibiofemoral subluksasyon, alt ekstremite aksı, eklem mesafesi

The effect of unicompartmental knee arthroplasty on lower extremity axis, tibiofemoral subluxation, and lateral knee joint distance

Abstract

Purpose: The aim of this study was to investigate the corrective effect of Oxford phase 3 medial unicompartmental knee arthroplasty (UKA) on the lower extremity axis, tibiofemoral subluxation and lateral joint distance.
Materials and Methods: The study included 105 knees that had undergone UKA. The Oxford Knee Score, EQ-5D-3LD and visual analog scale, and The Knee injury and Osteoarthritis Outcome Score were evaluated. Radiological evaluation was made of the lower extremity axis, tibiofemoral subluxation, and lateral knee joint distance.
Results: The postoperative mean improvement in the mechanical axis was 1.4° and in the tibiofemoral subluxation distance, 1.59 mm compared to preoperative values. The difference between the preoperative and postoperative lateral joint distance values was on average 0.25 mm lateral inner joint distance, 0.08 mm in the lateral middle joint distance and 0.34 mm in the outer joint distance. There was no significant difference in clinical results between the groups.
Conclusion: There were significant improvements in the postoperative period after cemented, cementless, and hybrid medial UKA in the measurements of lower extremity mechanical axis, tibiofemoral subluxation distance and lateral joint distances compared to the preoperative period.

Keywords

Unicompartmental, knee arthroplasty, tibiofemoral subluxation, lower extremity axis, joint distance

References

• 1. Blaney J, Harty H, Doran E, O'Brien S, Hill J, Dobie I, et al. Five-year clinical and radiological outcomes in 257 consecutive cementless Oxford medial unicompartmental knee arthroplasties. Bone Joint J. 2017;99-b(5):623-31. Epub 2017/04/30. doi: 10.1302/0301-620x.99b5.Bjj-2016-0760.R1. PubMed PMID: 28455471.
• 2. Mohammad HR, Kennedy JA, Mellon SJ, Judge A, Dodd CA, Murray DW. Ten-year clinical and radiographic results of 1000 cementless Oxford unicompartmental knee replacements. Knee Surg Sports Traumatol Arthrosc. 2020;28(5):1479-87. Epub 2019/06/19. doi: 10.1007/s00167-019-05544-w. PubMed PMID: 31209540; PubMed Central PMCID: PMCPMC7176592.
• 3. Murray DW, Parkinson RW. Usage of unicompartmental knee arthroplasty. Bone Joint J. 2018;100-b(4):432-5. Epub 2018/04/10. doi: 10.1302/0301-620x.100b4.Bjj-2017-0716.R1. PubMed PMID: 29629577.
• 4. Jennings JM, Kleeman-Forsthuber LT, Bolognesi MP. Medial Unicompartmental Arthroplasty of the Knee. J Am Acad Orthop Surg. 2019;27(5):166-76. Epub 2018/11/09. doi: 10.5435/jaaos-d-17-00690. PubMed PMID: 30407979.
• 5. Campi S, Pandit H, Hooper G, Snell D, Jenkins C, Dodd CAF, et al. Ten-year survival and seven-year functional results of cementless Oxford unicompartmental knee replacement: A prospective consecutive series of our first 1000 cases. Knee. 2018;25(6):1231-7. Epub 2018/08/29. doi: 10.1016/j.knee.2018.07.012. PubMed PMID: 30150067.
• 6. Veizi E, Fırat A, Tecimel O, Çepni Ş, Subaşı İÖ, Kılıçarslan K. The change in posterior tibial slope after cementless unicondylar knee arthroplasty. The Journal of Arthroplasty. 2020.
• 7. Petterson SC, Blood TD, Plancher KD. Role of alignment in successful clinical outcomes following medial unicompartmental knee arthroplasty: current concepts. Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine. 2020.
• 8. Khamaisy S, Zuiderbaan HA, van der List JP, Nam D, Pearle AD. Medial unicompartmental knee arthroplasty improves congruence and restores joint space width of the lateral compartment. The Knee. 2016;23(3):501-5.
• 9. Khamaisy S, Nam D, Thein R, Rivkin G, Liebergall M, Pearle A. Limb alignment, subluxation, and bone density relationship in the osteoarthritic varus knee. The journal of knee surgery. 2015;28(03):207-12.
• 10. Zuiderbaan HA, Khamaisy S, Thein R, Nawabi DH, Pearle AD. Congruence and joint space width alterations of the medial compartment following lateral unicompartmental knee arthroplasty. The bone & joint journal. 2015;97(1):50-5.
• 11. Kellgren J, Lawrence J. Radiological assessment of osteo-arthrosis. Annals of the rheumatic diseases. 1957;16(4):494.
• 12. Stempin R, Kaczmarek W, Stempin K, Dutka J. Midterm Results of Cementless and Cemented Unicondylar Knee Arthroplasty with Mobile Meniscal Bearing: A Prospective Cohort Study. Open Orthop J. 2017;11:1173-8. Epub 2018/01/02. doi: 10.2174/1874325001711011173. PubMed PMID: 29290853; PubMed Central PMCID: PMCPMC5721307.
• 13. Piperno M, Le Graverand M-PH, Conrozier T, Bochu M, Mathieu P, Vignon E. Quantificative evaluation of joint space width in femorotibal osteoarthritis: comparison of three radiographic views. Osteoarthritis and Cartilage. 1998;6(4):252-9.
• 14. Nam D, Khamaisy S, Gladnick BP, Paul S, Pearle AD. Is tibiofemoral subluxation correctable in unicompartmental knee arthroplasty? J Arthroplasty. 2013;28(9):1575-9. Epub 2013/04/10. doi: 10.1016/j.arth.2013.03.001. PubMed PMID: 23566701.
• 15. Buckland-Wright JC, Macfarlane DG, Lynch JA, Jasani MK, Bradshaw CR. Joint space width measures cartilage thickness in osteoarthritis of the knee: high resolution plain film and double contrast macroradiographic investigation. Ann Rheum Dis. 1995;54(4):263-8. Epub 1995/04/01. doi: 10.1136/ard.54.4.263. PubMed PMID: 7763102; PubMed Central PMCID: PMCPMC1005571.
• 16. Vasso M, Del Regno C, D'Amelio A, Viggiano D, Corona K, Schiavone Panni A. Minor varus alignment provides better results than neutral alignment in medial UKA. Knee. 2015;22(2):117-21. Epub 2015/02/11. doi: 10.1016/j.knee.2014.12.004. PubMed PMID: 25659441.
• 17. Berger RA, Della Valle CJ. Unicompartmental knee arthroplasty: indications, techniques, and results. Instr Course Lect. 2010;59:47-56. Epub 2010/04/27. PubMed PMID: 20415366.