| Objective:To investigate knee pain and function after Oxford unicompartmental knee arthroplasty(OUKA)in ’non-ideal’ patients.Methods:A retrospective study of 302 patients with anteromedial knee osteoarthritis(OA)treated with medial knee OUKA at the Affiliated Hospital of Chengde Medical College from 2018 to 2021.Among them,72 were male and 230 were female with at least 1 year of follow-up.Patients were divided into ideal and non-ideal groups.Age,gender,affected side,weight,body mass index(BMI),presence of lateral knee bones,presence of anterior knee pain,knee flexion mobility(range of motion)and knee function score were collected.The hip-knee-ankle angle(HKA)was measured on full-length X-rays of both lower limbs in the weight-bearing position before and after surgery.The operative time,hospital stay,intraoperative bleeding,postoperative drainage and postoperative complications were observed and recorded.Finally,the patients were divided into five subgroups and the knee function scores were compared between the subgroups.Results:1.There was no statistical difference between the two groups in terms of height,sex composition ratio,side of surgery,follow-up time,haemoglobin,erythrocyte pressure volume and C-reactive protein(P>0.05).2.There were no statistical differences in knee function scores,HKA,ROM and VAS scores(visual analogue scale,VAS)between the two groups before and at the end of the operation(p>0.05).3.Knee function scores,HKA,ROM and VAS scores were significantly improved compared to preoperative scores in both groups at the final follow-up,with a statistically significant difference(p < 0.05).4.When compared between the subgroups at the final follow-up,there was no significant difference in hospital for special surgery(HSS)scores between the five subgroups(p>0.05);there was a significant difference in Lysholm knee scores(p=0.010<0.05),and further Bonfresne post hoc tests showed a significant difference between group 2 and There was a significant difference between the 3 groups(P=0.006<0.05).5.There was no statistical difference between the two groups in terms of operative time,length of stay,intraoperative bleeding and postoperative drainage(p>0.05).6.There was no statistical difference in the incidence of complications between the two groups(p>0.05).Conclusions:In the "non-ideal" patient,medial knee Oxford unicondylar replacement resulted in significant improvement in knee pain and good functional recovery,with clinical outcomes similar to those of the ideal patient.Youngness,obesity,mild lateral knee redundancy and mild patellofemoral arthritis are no longer contraindications to UKA,and with appropriate preoperative indications,minimal intraoperative damage and early functional knee exercise,medial Oxford unicondylar replacement can be performed in "non-ideal" patients. |
