Femur-First Technique for Mobile Bearing Unicompartmental Knee Arthroplasty Results in Decreased Implant Variability and Early Improvements in Function and Survivorship

医学 生存曲线 单室膝关节置换术 植入 射线照相术 队列 运动范围 股骨 外科 胫骨 关节置换术 骨关节炎 口腔正畸科 核医学 内科学 癌症 替代医学 病理
作者
Joshua R. Labott,Samuel W. Carlson,Sheng‐Hsun Lee,Rafael J. Sierra
出处
期刊:Journal of Arthroplasty [Elsevier BV]
卷期号:38 (6): S60-S65 被引量:4
标识
DOI:10.1016/j.arth.2023.02.012
摘要

BackgroundHigher failure rates of unicompartmental knee arthroplasty (UKA) are seen with lower surgical volume. Surgical techniques that introduce less variability improving implant positioning may lead to improved survivorship. A femur-first (FF) technique has been described, but survivorship data compared to traditional tibia-first (TF) technique are under-reported. We report the results of mobile-bearing UKA using the FF technique compared to the TF technique with emphasis on implant position and survivorship.MethodsA total of 430 UKAs were performed by a single surgeon between 2007 and 2020. After 2012, there were 141 consecutive UKAs performed with the FF technique which were compared with 147 consecutive UKAs prior. Mean follow-up was 6 years (range, 2 to 13 years), average age was 63 years (range, 23 to 92 years), and there were 132 women. Postoperative radiographs were reviewed to determine implant positioning. Survivorship analyses were performed using Kaplan-Meier curves.ResultsThe FF resulted in significantly thinner polyethylene (3.4 ± 0.7 mm versus 3.7 ± 0.9 mm) (P = .002) and 4 mm or less bearing thickness in 94% of cases. At 5 years, there was an early trend toward improved survivorship free from component revision (98% for the FF group and 94% for the TF [P = .35]). The FF cohort had higher Knee Society Functional scores at final follow-up (P < .001).ConclusionCompared to traditional TF technique, the FF was more bone-preserving and improved radiographic positioning. The FF technique is an alternative method for mobile-bearing UKA and was associated with an improvement in implant survivorship and function.
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