Zwei-Jahres-Resultate mit einem patientenspezifischen metallischen Knieinterpositionsimplantat

详细信息    查看全文

• 作者：Dr. F.X. K?ck (1)
  J. Beckmann (1)
  P. Lechler (1)
  J. G?tz (1)
  J. Schaumburger (1)
  J. Grifka (1)
  
• 关键词：Unikompartimentelle Gonarthrose ; Hemiarthroplastik ; Interpositionelle Implantate ; Implantatdislokation ; Patientenspezifisch ; Unicompartmental knee arthritis ; Hemiarthroplasty ; Interpositional implant ; Implant dislocation ; Patient ; specific
• 刊名：Der Orthop?de
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：40
• 期：12
• 页码：1103-1110
• 全文大小：482KB
• 参考文献：1. (o A) (2007) Australian Orthopaedic Association National Joint Replacement Registry Annual Report
  2. (o A) (2008) Treatment of Osteoarthritis of the Knee (Non-Arthroplasty) -Full Guideline, Adopted by the American Academy of Orthopaedic Surgeons, Board of Directors
  3. Bailie AG, Lewis PL, Brumby SA et al (2008) The Unispacer knee implant: early clinical results. J Bone Joint Surg [Br] 90:446-50
  4. Beard DJ, Pandit H, Ostlere S et al (2007) Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg [Br] 89:1602-607
  5. Bellamy N (2005) The WOMAC Knee and Hip Osteoarthritis Indices: development, validation, globalization and influence on the development of the AUSCAN Hand Osteoarthritis Indices. Clin Exp Rheumatol 23:S148–S153
  6. Bellamy N, Buchanan WW, Goldsmith CH et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833-840
  7. Brinkman JM, Lobenhoffer P, Agneskirchner JD et al (2008) Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg [Br] 90:1548-557
  8. Cartier P, Khefacha A, Sanouiller JL, Frederick K (2007) Unicondylar knee arthroplasty in middle-aged patients: a minimum 5-year follow-up. Orthopedics 30:62-5
  9. Cartier P, Sanouiller JL, Grelsamer RP (1996) Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 11:782-88 CrossRef
  10. Clarius M, Becker JF, Schmitt H, Seeger JB (2009) The UniSpacer: correcting varus malalignment in medial gonarthrosis. Int Orthop 33:1531-536 CrossRef
  11. Dahl A, Robertsson O, Lidgren L et al (2010) Unicompartmental knee arthroplasty in patients aged less than 65. Acta Orthop 81:90-4 CrossRef
  12. Emerson RH Jr, Potter T (1985) The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis. J Bone Joint Surg [Am] 67:208-12
  13. Friedman MJ (2003) UniSpacer. Arthroscopy 19(Suppl 1):120-21
  14. Furnes O, Espehaug B, Lie SA et al (2007) Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with cement. J Bone Joint Surg [Am] 89:519-25
  15. Hallock RH (2005) The UniSpacer: a treatment alternative for the middle-aged patient. Orthop Clin North Am 36:505-12 CrossRef
  16. Hallock RH, Fell BM (2003) Unicompartmental tibial hemiarthroplasty: early results of the UniSpacer knee. Clin Orthop Relat Res 416:154-63 CrossRef
  17. Hang JR, Stanford TE, Graves SE et al (2010) Outcome of revision of unicompartmental knee replacement. Acta Orthop 81:95-8 CrossRef
  18. Hui C, Salmon LJ, Kok A et al (2010) Long-Term survival of high tibial osteotomy for medial compartment osteoarthritis of the knee. Am J Sports Med 92:187-95
  19. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13-4
  20. Jarvenpaa J, Kettunen J, Miettinen H, Kroger H (2010) The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8-7 years follow-up study of 49 patients. Int Orthop 34:649-53 CrossRef
  21. Josten C, Tiemann AH (2003) Unicondylar knee arthroplasty -indications and outcome. Zentralbl Chir 128:60-3 CrossRef
  22. Koeck FX, Weingartner D, Beckmann J et al (2010) Operative treatment of the unicompartmental knee arthritis -results of a nationwide survey in 2008. Z Orthop Unfall 149:153-59 CrossRef
  23. Koeck FX, Perlick L, Luring C et al (2009) Leg axis correction with ConforMIS iForma (interpositional device) in unicompartmental arthritis of the knee. Int Orthop 33:955-60 CrossRef
  24. Koeck FX, Rath B, Springorum HR et al (2010) Removal and successful re-implantation of a customized interpositional knee device following an early postoperative infection: a case report. Cent Eur J Med 5:442-46 CrossRef
  25. Koskinen E, Paavolainen P, Eskelinen A et al (2007) Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop 78:128-35 CrossRef
  26. Kuipers BM, Kollen BJ, Bots PC et al (2010) Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee 17:48-2 CrossRef
  27. Li MG, Yao F, Joss B et al (2006) Mobile vs. fixed bearing unicondylar knee arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee 13:365-70 CrossRef
  28. MacIntosh DL (1958) Hemi-arthroplasty of the knee using a space occupying prosthesis for painful varus and valgus deformities. Proceedings of the joint meeting of orthpaedic associations of the English speaking world. J Bone Joint Surg [Am] 40:1431
  29. MacIntosh DL, Hunter GA (1972) The use of the hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the knee. J Bone Joint Surg [Br] 54:244-55
  30. Marx A, Ossen R, Ellermann A (2009) Was gibt es Neues bei der medialen Gonarthrose? Der Unispacer. Arthroskopie 22:217-22 CrossRef
  31. McKeever DC (2005) The classic: tibial plateau prosthesis.1960. Clin Orthop Relat Res 440:4- CrossRef
  32. McKeever DC (1960) Tibial plateau prosthesis. Clin Orthop Relat Res 18:86-5
  33. Niinimaki TT, Murray DW, Partanen J et al (2010) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee [Epub ahead of print]
  34. Oduwole KO, Sayana MK, Onayemi F et al (2010) Analysis of revision procedures for failed unicondylar knee replacement. Ir J Med Sci 179:361-64 CrossRef
  35. Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg [Br] 43-B:752-57
  36. Outerbridge RE (2001) The etiology of chondromalacia patellae. 1961. Clin Orthop Relat Res 289:5- CrossRef
  37. Price AJ, Svard U (2010) A second decade lifetable survival analysis of the oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 469:174-79 CrossRef
  38. Ranawat CS, Flynn WF Jr, Saddler S et al (1993) Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res 286:94-02
  39. Robertsson O, Bizjajeva S, Fenstad AM et al (2010) Knee arthroplasty in Denmark, Norway and Sweden. Acta Orthop 81:82-9 CrossRef
  40. Scott RD (2003) UniSpacer: insufficient data to support its widespread use. Clin Orthop Relat Res 416:164-66 CrossRef
  41. Scott RD, Joyce MJ, Ewald FC, Thomas WH (1985) McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis. Long-term clinical follow-up and current indications. J Bone Joint Surg [Am] 67:203-07
  42. Sisto DJ, Mitchell IL (2005) UniSpacer arthroplasty of the knee. J Bone Joint Surg [Am] 87:1706-711
  43. Springer BD, Scott RD, Sah AP, Carrington R (2006) McKeever hemiarthroplasty of the knee in patients less than sixty years old. J Bone Joint Surg [Am] 88:366-71
  44. Staubli AE, Jacob HA (2009) Evolution of open-wedge high-tibial osteotomy: experience with a special angular stable device for internal fixation without interposition material. Int Orthop 34(2):167-72 CrossRef
  45. Swanson AB, Swanson GD, Powers T et al (1985) Unicompartmental and bicompartmental arthroplasty of the knee with a finned metal tibial-plateau implant. J Bone Joint Surg [Am] 67:1175-182
  46. Tabor OB Jr, Tabor OB, Bernard M, Wan JY (2005) Unicompartmental knee arthroplasty: long-term success in middle-age and obese patients. J Surg Orthop Adv 14:59-3
  47. Whitehouse SL, Crawford RW, Learmonth ID (2008) Validation for the reduced Western Ontario and McMaster Universities Osteoarthritis Index function scale. J Orthop Surg (Hong Kong) 16:50-3
  48. Whitehouse SL, Lingard EA, Katz JN, Learmonth ID (2003) Development and testing of a reduced WOMAC function scale. J Bone Joint Surg [Br] 85:706-11
  
• 作者单位：Dr. F.X. K?ck (1)
  J. Beckmann (1)
  P. Lechler (1)
  J. G?tz (1)
  J. Schaumburger (1)
  J. Grifka (1)
  
  1. Asklepios Klinikum Bad Abbach, Klinik und Poliklinik für Orthop?die, Universit?t Regensburg, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland
  

文摘

Background Besides the primary goal of functional improvement and pain reduction, the operative treatment of unicompartmental arthritis in younger patients is focused on preservation of intact bone and joint structures. The question arises whether an interpositional knee implant based on magnetic resonance imaging (MRI) data can be an alternative treatment option to the established procedures of high tibial osteotomy and unicompartmental knee arthroplasty. Methods From June 2004 to May 2008 a total of 33 patients suffering from unicompartmental knee arthritis received a patient-specific interpositional implant (31 medial and 2 lateral) within a single arm trial. The mean follow-up time was 26.6?months (range 1-8?months) and the mean age of the patients was 54.5?years (range 39-5?years). In addition to the clinical results the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) function scale and the Knee Society scores were measured. A descriptive data analysis, a variance analysis for repeated measurements and a determination of significance level were carried out. Results The 2-?year results showed a significant improvement in the WOMAC function scale as well as the Knee Society scores. The knee function after 2 years was comparable to the preoperative situation with an extension to flexion of 0/2/130°. The dislocation rate was 6% and the overall revision rate 21%. Conclusion Despite acceptable functional results a significant pain relief, a complete preservation of bone and a lower rate of dislocations compared to the off-the-shelf Unispacer implant there were only limited indications for the customized interpositional knee implant with respect to the given contraindications due to the high 2?year revision rate.