| Objective: For end-stage osteoarthritis of the knee(KOA),treatments such as painkillers,ice,and arthroscopes often do not respond well.unicompartmental knee arthroplasty(UKA)is a well-established surgical treatment for KOA,which has the advantages of shorter operative time,reduced hospital stay,less trauma,reduced surgical bleeding,accelerated postoperative recovery,reduced perioperative pain,and the preservation of the cruciate ligament and proprioceptive motor sensation.Currently,it is generally believed that UKA is more suitable for patients with full thickness of knee cartilage loss.However,a small number of patients with partial thickness of knee cartilage loss,obvious clinical symptoms and other indications of UKA are ineffective after conservative treatment or other non-knee protection treatment.Are these patients suitable for UKA? This study intends to conduct a retrospective comparative analysis on patients with partial and full thickness of knee cartilage loss who have been treated with UKA in our hospital,so as to provide a certain reference for whether UKA is feasible for patients with partial thickness of knee cartilage loss who have clinical symptoms and have failed conservative treatment.Methods:Data of all patients receiving UKA treatment in our hospital from January 2018 to June 2021 were retrospectively collected.Preoperative MRI of the affected knee in our hospital and follow-up results of at least 1 year after surgery were required.According to preoperative MRI data,cartilage injury was divided into two groups by ICRS classification:(1)partial thickness of cartilage loss(PTCL),both femur and tibial sides of the knee reached grade III ICRS,or one side reached grade III and the other side reached grade IV.(2)full thickness of cartilage loss(FTCL),both femur and tibial sides of the knee reached grade IV ICRS.Evaluation methods:(1)Knee flexion and extension were analyzed by measuring Range of Movement(ROM).Knee function was evaluated by the Knee Society Score(KSS)and the Hospital for Special Surgery(HSS).(2)The Visual Analogue Scale(VAS)was used to evaluate the patients’ knee pain.(3)Postoperative complications were collected,including prosthesis dislocation,incision infection,periprosthesis infection,prosthesis loosening,delayed incision healing and lower limb vein thrombosis.SPSS system was used for statistical analysis of the data,independent T-test was used for comparison between groups,measurement data was expressed by(χ±s),count data was compared by Chi-square test,the significance level was set as 0.05,p < 0.05 indicated significant difference.Results: From January 2018 to June 2021,a total of 194 patients in our hospital received UKA treatment,of which 80 cases were excluded due to no preoperative MRI image results or no follow-up results.Finally,there were 24 patients in the partial thickness of cartilage loss(PTCL)group and 90 patients in the full thickness of cartilage loss(FTCL)group.There were no significant differences between FTCL group and PTCL group in age,height,weight,BMI and mean follow-up time.Preoperative data,preoperative knee range of motion,HSS score,KSS clinical score,KSS functional score and VAS score were not significantly different between the two groups,P > 0.05.For postoperative data,the average knee motion of the FTCL group was 132.06±8.34°(range 115-145°),the average KSS clinical score was 99.27±2.60 points(range 90-100 points),and the average KSS functional score was 99.63±2.36 points(range 80-100 points).The average HSS score was 99.38±2.20 points(range 81-100 points),and the average VAS score was 1.43±1.15 points(range 0-5 points).In the PTCL group,the mean knee range of motion was 129.58±8.59°(range 110-130°),the mean KSS clinical score was 88.67±6.63 points(range 73-97 points),and the mean KSS functional score was 85.42±10.52 points(range 65-100 points).The average HSS score was 91.71±4.66 points(range 81-98 points),and the average VAS score was 2.71±1.52 points(range 1-6 points).In conclusion,the average postoperative HSS score,average KSS clinical score,average KSS functional score and average VAS score of FTCL group were superior to PTCL group,with statistical significance(P < 0.05),while there was no significant statistical difference in knee range of motion(P > 0.05).Conclusions: For patients with partial thickness of knee cartilage loss(PTCL),although some of them achieved good clinical results in the short term follow-up,we believe that compared with patients with full thickness of knee cartilage loss(FTCL),UKA treatment is not recommended. |
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