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Title: [Analysis of the influence of tibial component posterior slope angle on short- and mid-term effectiveness of unicompartmental knee arthroplasty].
Author: Wu Y, Lu W, Li Z, Xie H, Tang L, Pan E.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2022 Feb 15; 36(2):189-195. PubMed ID: 35172404.
Abstract:
OBJECTIVE: To investigate the influence of tibial component posterior slope angle (TCPSA) on the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA). METHODS: The clinical data of the patients with anterior medial knee osteoarthritis (KOA) treated by UKA between May 2014 and May 2019 were retrospectively analysed. There were 10 males and 45 females with a median age of 68 years (range, 49-83 years). The body mass index (BMI) was 27.63-52.26 kg/m ², with an average of 40.04 kg/m ². There were 28 cases of left knee, 21 cases of right knee, and 6 cases of double knees. The disease duration was from 7 months to 12 years, with an average of 4.33 years. Measurements of posterior tibial slope (PTS) and TCPSA were performed on the knee joint X-ray films of patients before operation and at last follow-up, respectively. According to the postoperative TCPSA, patients were divided into TCPSA<4° group (group A), 4°≤TCPSA<9° group (group B), and TCPSA>9° group (group C) with the quartile method. Baseline data such as age, gender, BMI, and affected side were compared among the 3 groups, as well as the Hospital for Special Surgery (HSS) score, visual analogue scale (VAS) score, and range of motion (ROM) before and after operation. RESULTS: All 55 patients were followed up 17-72 months, with an average of 36 months. No complication such as prosthesis loosening, infection, tibial plateau collapse, and dislocation of the meniscus pad occurred. The preoperative PTS was (7.38±3.37)°, and the postoperative TCPSA was (6.25±3.22)°, showing no significant difference ( t=1.815, P=0.074). According to postoperative TCPSA, there were 12 knees in group A, 32 in group B, and 17 in group C. There was no significant difference in age, gender, BMI, affected side, and preoperative HSS scores, ROM, and VAS scores among the 3 groups ( P>0.05). At last follow-up, the HSS scores, ROM, and VAS scores of the 3 groups significantly improved when compared with preoperative ones ( P<0.05). There was no significant difference in the difference of the above indicators before and after operation among 3 groups ( P>0.05). CONCLUSION: The patients with anterior medial KOA may have good short- and mid-term effectiveness after UKA. Among the recommended range of TCPSA, there is no significant influence on the postoperative short- and mid-term effectiveness. Long-term effectiveness need to extend the follow-up time and expand the sample size for research verification. 目的: 探讨胫骨假体后倾角（tibial component posterior slope angle，TCPSA）对单髁关节置换术（unicompartmental knee arthroplasty，UKA）后近中期疗效的影响。. 方法: 回顾分析2014年5月—2019年5月采用UKA治疗的55例（61膝）前内侧膝关节骨关节炎（knee osteoarthritis，KOA）患者临床资料。男10例，女45例；年龄49～83岁，中位年龄68岁。身体质量指数（body mass index，BMI）为27.63～52.26 kg/m ²，平均40.04 kg/m ²。左膝28例，右膝21例，双膝6例。病程7个月～12年，平均4.33年。分别于患者术前及末次随访时膝关节X线片上测量胫骨后倾角（posterior tibial slope，PTS）及TCPSA，根据术后TCPSA按四分位法分为TCPSA<4° 组（A组）、4°≤TCPSA<9° 组（B组）、TCPSA>9° 组（C组）。比较3组年龄、性别、BMI及患膝侧别等基线资料，以及手术前后美国特种外科医院（HSS）评分、疼痛视觉模拟评分（VAS）及膝关节活动度（range of motion，ROM）。. 结果: 术后55例患者均获随访，随访时间17～72个月，平均36个月。均未出现假体松动、感染、胫骨平台塌陷、半月板衬垫脱位等并发症。所有患者术前PTS为（7.38±3.37）°，术后TCPSA为（6.25±3.22）°，差异无统计学意义（ t=1.815， P=0.074）。根据术后TCPSA分组，A组12膝、B组32膝、C组17膝。3组年龄、性别、BMI、患膝侧别及术前HSS评分、ROM、VAS评分等比较差异均无统计学意义（ P>0.05），具有可比性。末次随访时，3组患者HSS评分、ROM及VAS评分均较术前改善，差异有统计学意义（ P<0.05）；3组间上述指标手术前后差值比较，差异均无统计学意义（ P>0.05）。. 结论: UKA治疗前内侧KOA近中期疗效较好；术后TCPSA在推荐范围内时对近中期疗效无明显影响，远期结果尚需延长随访时间及扩大样本量进行研究验证。.

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