Zhongguo Gu Shang. 2026 Mar 25;39(3):254-62. doi: 10.12200/j.issn.1003-0034.20240929.
ABSTRACT
OBJECTIVE: To explore clinical efficacy of fixed-platform unicompartmental knee arthroplasty (UKA) with biologic femoral condyle prosthesis in treating medial compartment osteoarthritis of knee joint.
METHODS: A total of 89 patients with medial compartment osteoarthritis of knee joint who were admitted from January 2021 to December 2023 were selected, and divided into biological group and bone cement group according to different treatment methods. There were 45 patients in biological group, including 18 males and 27 females;aged from 54 to 68 years old with an average of (61.42±6.28) years old;the course of disease ranged from 1 to 5 months with an average of (3.74±0.52) months;28 patients with gradeⅡand 17 patients with grade Ⅲ according to Kellgren-Lawrence (K-L) classification;biological femoral head prosthesis was used. There were 44 patients in bone cement group, including 20 males and 24 females;aged from 52 to 69 years old with an average of (61.59±6.18) years old;the course of disease ranged from 0 to 6 months with an average of (3.80±0.49) months;28 patients with grade Ⅱand 16 patients with grade Ⅲ according to K-L classification;bone cement type femoral head prosthesis was used. Operative time, intraoperative blood loss, intraoperative tourniquet usage time, postoperative drainage volume, hospital stay, and complications between two groups were compared. The changes of Oxford University knee score (OKS), Western Ontario and McMaster Universities osteoarthritis index(WOMAC), and knee joint range of motion(ROM) between two groups before operation and after operation at 1, 3, and 6 months, visual analogue scale(VAS) before operation and after operation at 1, 3, 6 and 12 months were used to evaluate pain relief, changes of typeⅠcollagen carboxy-terminal peptideβ-specific sequence (β-CTX), total N-terminal propeptide of typeⅠprocollagen (tPⅠNP), and intact parathyroid hormone (iPTH) between two groups before operation and 6 months after operation were compared between two groups.
RESULTS: The usage time of hemostatic band during operation and hospital stay in biological group were (54.23±5.69) min and (13.13±1.36) days respectively, while those in bone cement group were (62.11±6.34) min and (10.02±1.27) days respectively;there were statistically significant differences between two groups (P<0.05). There were no statistically significant differences in operation time, intraoperative blood loss, and postoperative drainage volume between two groups (P>0.05). Postoperative OKS and WOMAC scores of biological group at 3 and 6 months were (21.13±2.45), (19.44±1.98), (25.14±2.65), (20.23±2.16) points respectively, which were all lower than those of cement group (24.83±2.57), (23.15±2.46), (29.33±2.98), (24.55±2.67) points;ROM was (119.42±12.57)° and (128.56±13.15)°, which were greater than those of cement group (112.34±12.58)° and (120.44±12.73)°;there were statistically significant differences between two groups (P<0.05). Postoperative VAS of biological group at 1 and 3 months were (2.23±0.24) and (1.92±0.23) respectively, which were higher than those of cement group (1.87±0.21) and (1.67±0.18), and the differences were statistically significant (P<0.05);however, there were no statistically significant differences in postoperative VAS between two groups at 6 and 12 months (P>0.05). At six months after operation, there were no significant differences inβ-CTX, tPⅠNP, and iPTH between two groups (P>0.05). There were no occurrences of implant-related complications such as sterile loosening or radiolucent lines of the prosthesis in both groups.
CONCLUSION: For the treatment of medial compartment osteoarthritis of knee joint with fixed-platform unicompartmental knee arthroplasty (UKA) with biologic femoral condyle prosthesis, bone cement type femoral condyle prosthesis results in less pain in the short term, while biological type femoral condyle prosthesis has a more advantageous long-term effect, which could improve knee joint function. Clinically, the type of prosthesis could be selected based on individual circumstances.
PMID:41930385 | DOI:10.12200/j.issn.1003-0034.20240929
