METHODS: This was a prospective case series study. Non-reopererated patients initially treated with resurfacing condylar miniprothesis (HemiCAP/UniCAP) were evaluated clinically and radiographically at 7-10 years follow-up (mean 9 years). The clinical examination included the Knee Society Score (KSS) and Visual Analogue Scale (VAS) pain score and EQ5D. The radiographic examination included the Kellgren-Lawrence (KL) grade for investigate of OA progression. A comparison analysis of the preoperative and follow-up subjective outcome data and a Kaplan-Meier implant survival analysis were performed.
RESULTS: Twenty-three patients were included in the study (9 HemiCAP and 14 UniCAP). There were seven revisions (one HemiCap and six UniCap respectively) (30%) and three patients had died. Follow-up examinations were performed on 10 patients. When comparing follow-up with the preoperative state, there were significant increases in the KSS objective (50.0 ± 8.3) vs. 90.0 ± 6.3)) and KSS function (45.0 ± 11.7) vs. 85.0 ± 4.7)) scores, a decrease in the pain VAS score (7.0 ± 0.9) vs. (4.0 ± 1.9)). Radiographic evaluation demonstrated increase in osteoarthritis development with a KL medial score (2.0 ± 0.6) and KL lateral score (1.4 ± 0.6) vs. (2.0 ± 0.9)).The EQ5D-score was 86 ± 8.4 and patients Health-score was 85 ± 18).
CONCLUSIONS: Resurfacing implant treatment for early OA in patients above 65 years can require revision to knee arthroplasty in 30% of patients. But in patients that are not revised long-term improvements in subjective clinical outcome was demonstrated. This suggests that even elderly patients with isolated cartilage lesions or early OA might benefit from the limited invasive resurfacing implant treatment.
METHODS: IV.
方法:这是一项前瞻性病例系列研究。在7-10年的随访(平均9年)中,对最初接受reoperated突微型假体(HemiCAP/UniCAP)治疗的非重复评估患者进行了临床和影像学评估。临床检查包括膝关节协会评分(KSS)和视觉模拟评分(VAS)疼痛评分和EQ5D。影像学检查包括Kellgren-Lawrence(KL)等级,以调查OA的进展。对术前和随访主观结果数据进行比较分析,并进行Kaplan-Meier植入物生存分析。
结果:23例患者纳入研究(9例HemiCAP和14例UniCAP)。有7例修订(分别为1例HemiCap和6例UniCap)(30%),3例患者死亡。对10例患者进行随访检查。当随访与术前状态比较时,KSS目标(50.0±8.3)与90.0±6.3))和KSS功能(45.0±11.7)与85.0±4.7))得分,疼痛VAS评分降低(7.0±0.9)与(4.0±1.9))。影像学评估显示骨关节炎的发展增加,KL内侧评分(2.0±0.6)和KL外侧评分(1.4±0.6)与(2.0±0.9))。EQ5D评分为86±8.4,患者健康评分为85±18)。
结论:对于65岁以上的早期OA患者,表面置换术治疗可能需要修正膝关节置换术的患者占30%。但在未修正的患者中,主观临床结果得到了长期改善。这表明,即使患有孤立性软骨损伤或早期OA的老年患者也可能受益于有限的侵入性表面修复植入治疗。
方法:IV.