Does the overhang of tibial component in fixed bearing medial unicondylar knee arthroplasty affect 1-year results?

Öz

Aim: Unicondylar knee arthroplasty (UKA) is an effective treatment for single-compartment knee arthrosis. The compatibility of the size of the components with the bone is one of the factors determining patient satisfaction. With this study we aimed to investigate the effect of size concordance of the tibial component and bone in fixed bearing UKA on functional scores and pain.
Methods: Demographic data, preoperative and postoperative 1-year visual analog pain scale (VAS) and Oxford Knee Scores (OKS) were collected from 43 patients operated by a single surgeon with a fixed bearing UKA implant (Zimmer UKA, Warsaw USA) for this prospective cohort study. Patients were then grouped according to radiological compliance of the tibial component to the bone as perfect match or overhang, and the groups were compared in terms of pain and functional scores.
Results: Among 43 patients included in the study, 9 (20.9%) were males and 34 (79.1%) were females. The mean age of the patients was 62.1 (8.1) years. The median VAS and OKS scores of the patients before surgery were 6 (3-8) and 26 (21-30), respectively. Postoperatively, VAS score decreased to 1 (0-2), while OKS increased to 44 (37-48) (P<0.001 for both). There were only 3 patients with underhang. Twenty-two (52.1%) patients had perfect match and 18 (41.9%) had an overhang from the bone surface. There was no patient with an overhang greater than 3mm. The VAS and OKS scores at post-operative 1-year of 18 patients with overhang and 22 patients without bone overhang were similar (P=0.674 and P=0.873, respectively).
Conclusion: The overhang of the tibial component in fixed bearing unicondylar knee arthroplasty is common, however, this does not affect functional results in 1-year follow-up. Nevertheless, the sizing of the component should be checked by adequate means.

Anahtar Kelimeler

• Unicondylar
• Knee
• Arthroplasty
• Function
• Implant size

Sabit tip medial unikondiler diz artroplastisinde tibial komponentin kemik yüzeyden taşması 1 yıllık sonuçları etkiler mi?

Öz

Amaç: Unikondiler diz artroplastisi (UDA) tek kompartman artrozunda etkinliği kanıtlanmış bir tedavidir. Kemik ile implant bileşenlerinin uyumu hasta memnuniyetini etkileyen faktörlerden biridir. Bu çalışma ile kemik ve tibial bileşen uyumunun ağrı ve fonksiyon skorları üzerindeki etkisini incelemeyi amaçladık.
Yöntemler: Bu prospektif kohort çalışmasında tek cerrah tarafından opere edilmiş 43 sabit tip UDA (Zimmer UKA, Warsaw, ABD) hastasının demografik verileri, cerrahi öncesi ve cerrahi sonrası birinci yıldaki vizüel analog ağrı skalası (VAS) ve Oxford Knee Score (OKS) sonuçları incelenmiştir. Hastalar radyolojik olarak kemik yüzey ile implantın uyumuna göre mükemmel uyum ve taşma olarak gruplanmıştır. Ardından grupların ağrı ve fonksiyon skorları karşılaştırılmıştır.
Bulgular: İncelenen 43 hastanın 9’u (%20,9) erkek ve 34’ü (%79,1) kadındır. Ortalama yaş 62,1 (8,1) yıldı. Cerrahi öncesi VAS ve OKS ortanca değerleri sırasıyla 6 (3-8) ve 26 (21-30) idi. Cerrahi sonrasında VAS 1’e (0-2) düşerken OKS 44’e (37-48) yükselmiştir (her ikisi için P<0,001). Sadece 3 hastada implant kemikten daha küçüktü. 22 (%52,1) hastada kemik ile protez arasında tam uyum mevcuttu. 18 (%41,9) hastada ise kemik yüzeyden taşma izlenmiştir, ancak bu hastalardan hiçbirinde fark 3 mm’den fazla değildir. Mükemmel uyum ve taşma grubunun cerrahiden sonraki birinci yıl VAS ve OKS sonuçları karşılaştırıldığında anlamlı bir fark olmadığı görülmüştür (sırasıyla P=0,674 ve P=0,873).
Sonuç: Sabit tip unikondiler diz artroplastisinde taşma sık görülürken bunun cerrahi sonrası birinci yıl ağrı ve fonksiyonel sonuçlar üzerinde bir etkisi yoktur. Yine de implant seçimi yapılırken taşmanın önüne geçmek için gerekli önlemler alınmalıdır. 

Anahtar Kelimeler

• Unikondiler
• Diz
• Artroplasti
• Fonksiyon
• İmplant büyüklüğü

Kaynakça

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