Prosthesis position: UKA prosthesis Overhang hian eng nge a rah chhuah ang?

Unicompartmental knee arthroplasty (UKA) hi total knee arthroplasty (TKA) ai chuan surgical alternative a ni a, hei hi unicompartmental osteoarthritis enkawlna atan a ni. Mahse, UKA hlawhchhamna rate data atanga a lan dan chuan kum 7 chhunga dam rei zat chu 74% a ni a, hei hi TKA (92%) aiin a hniam zawk hle. Damlote thil tihsual hian hlawhchhamna a tipung a, chu chu damlo naupang zawk leh body mass index (BMI) sang zawkte hian UKA hlawhchhamna a tipung thei a, mahse surgical technical errors hi hlawhchham hmaa risk factor pawimawh takah ngaih a ni. UKA-ah chuan prosthetic alignment leh overhang (overhang) tha ber neih chu thil harsa tak a ni. Tibial prosthesis hi soft tissue irritation tlem thei ang bera size leh implant tur a ni a, medial tibial overhang 3 mm aia tam chu Oxford Knee Score (OKS) tlahniam leh natna tihpunna tur risk factor lian tak a nih thu hmuhchhuah a ni bawk. He zirchianna hian a tum ber chu UKA-a clinical leh imaging outcome zawng zawng tehna a ni. Secondary objective chu prosthetic malalignment leh overhang-in implant damchhuahna a nghawng dan tehna a ni.Unicompartmental knee arthroplasty (UKA) hi unicompartmental osteoarthritis enkawlna atan total knee arthroplasty (TKA) ai chuan surgical alternative a ni. Mahse, UKA hlawhchhamna rate data atanga a lan dan chuan kum 7 chhunga dam rei zat chu 74% a ni a, hei hi TKA (92%) aiin a hniam zawk hle. Damlote thil tihsual hian hlawhchhamna a tipung a, chu chu damlo naupang zawk leh body mass index (BMI) sang zawkte hian UKA hlawhchhamna a tipung thei a, mahse surgical technical errors hi hlawhchham hmaa risk factor pawimawh takah ngaih a ni. UKA-ah chuan prosthetic alignment leh overhang (overhang) tha ber neih chu thil harsa tak a ni. Tibial prosthesis hi soft tissue irritation tlem thei ang bera size leh implant tur a ni a, medial tibial overhang 3 mm aia tam chu Oxford Knee Score (OKS) tlahniam leh natna tihpunna tur risk factor lian tak a nih thu hmuhchhuah a ni bawk. He zirchianna hian a tum ber chu UKA-a clinical leh imaging outcome zawng zawng tehna a ni. Secondary objective chu prosthetic malalignment leh overhang-in implant dam khawchhuahna a nghawng dan tehna a ni.

Thiltih dan

He zirchianna hi single-center study a ni a, January 2008 atanga December 2017 thleng khan kan institution-a medial UKA nei mipa leh hmeichhia te an tel a, damlo zawng zawngte chu standard method hmangin UKA an nei vek a ni.UKA atana excclusion criteria-ah hian moderate to severe valgus deformity, patellofemoral compartment arthritis, posterior tibial displacement, leh instability te a tel a ni. Clinical leh imaging result hi clinical record leh institutional database te retrospective review atanga lak a ni. Fixed-platform leh movable-platform UKA zawng zawng tan femoral coronal leh sagittal angle (FCA leh FSA) leh tibial coronal leh sagittal angle (TCA leh TSA) te chu radiograph-ah teh a ni a, a hnuaia tarlan ang hian.

Nghawngchhuah

Follow-up zat chu kum 4.9 (kum 0.03 atanga kum 10.2) a ni. Revision surgery 36 kan hmuchhuak a, operation hnuah kum 3.7 (kum 0.03 atanga 8.7) a ni a, cumulative failure rate chu 14.2% a ni. Kum 5 dam chhung chu 88.0% (95% confidence interval [CI]=82.0% to 91.0%) niin kum 10 dam chhung chu 70.0% (95% CI=56.0% to 80.0%) a ni.

Revision chhan tam ber chu prosthesis alignment tha lo/unstable (31%), mechanical failure (22%), osteoarthritis zual zel (14%), leh natna sawifiah theih loh (8%) te a ni.

UKA zinga 11.9% chauhvin alignment leh prosthetic coverage duh zawng zawng an nei vek a ni. UKA hlawhchhamna tur risk factor lian tak a ni lo (10.0% failure rate, p=0.090), prosthesis hnunglam overhang (25.0%, p=0.006) leh medial overhang of the prosthesis (38.2%, p<0.001) te chu UKA hlawhchhamna risk factor lian tak a ni.

Sawiho

He zirchiannaah hian medial UKA clinical leh imaging outcome leh prosthetic alignment leh overhang-in nghawng a neih dan kan zirchiang a. Kum 5 leh kum 10 chhunga damchhuah zat chu 88% leh 70% a ni a, TKA aiin a hniam zawk hle. revision atana chhinchhiahna langsar ber chu prosthetic alignment tha lo, mechanical failure, leh osteoarthritis zual zel te a ni. Prosthesis alignment tha lo leh posterior leh medial overhang te hi UKA revision atana risk factor pawimawh tak a ni.

Literature chhuah tawhah chuan UKA hlawhchhamna chhan ber pahnih chu aseptic loosening leh osteoarthritic progression te an ni a, an pahnih hian load distribution inang lo tak an nei a, hei hian a chunga kan sawi tak UKA failure chhan hi mechanical in nature a ni thei tih a tilang. He evidence hian prosthesis alignment tha lo hi UKA failure hmasa ber thlentu a nih thu a tarlang. Chuvangin UKA prosthesis alignment tihchangtlun nan leh overhang awm zat tihtlem nan surgical techniques tihchangtlun tum a ngai niin kan ngai.

Tuna kan thil hmuhchhuahte hian prosthesis alignment/overhang tha lo leh revision hlauhawmna inzawmna nghet tak hian he zirchiannaa failure rate sang tak hmuh chhuah theihna tur mechanism awm thei a nih thu a tarlang. Surgeon-in prosthesis dahnaah a dik reng thei hi UKA damchhuahna rate tihsan nana puitu pawimawh tak a ni.

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