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Abstract：
BACKGROUND: The component design and fixation method of joint arthroplasty may affect component migration and survival. The aim of this study was to compare fixation of cementless twin-peg (CLTP), cemented twin-peg (CTP) and cemented single-peg (CSP) femoral components of medial unicompartmental knee replacement (UKR).
METHODS: Eighty patients (mean age = 63 years, 48 males) with medial knee osteoarthritis were randomized in three ways to CLTP (n = 25), CTP (n = 26) or CSP (n = 29) femoral UKR components. The patients were followed 5 years postoperatively with RSA, bone mineral density (BMD), PROMs and radiological evaluation of radiolucent lines (RLL), femoral component flexion angle and complications.
RESULTS: At the 5-year follow-up, femoral component total translation was comparable between the three groups (p = 0.60). Femoral component internal rotation was 0.50° (95% CI 0.3; 0.69) for the CLTP group, 0.58° (95% CI 0.38; 0.77) for the CTP group and 0.25° (95% CI 0.07; 0.43) for the CSP group (p = 0.01). BMD decreased peri-prosthetically (range - 11.5%; - 14.0%) until 6-month follow-up and increased toward the 5-year follow-up (range - 3.6%; - 5.8%). BMD change did not correlate with component migration. Lower flexion angle was correlated with higher 5-year subsidence, total translation, varus rotation and maximum total point motion (p = 0.01). Two patients (1 CLTP, 1 CTP) had RLL in the posterior zone. There were two revisions.
CONCLUSIONS: At 5-year follow-up, fixation of UKA femoral components with twin-peg was not superior to the single-peg design. Cementless and cemented twin-peg femoral components had similar fixation. A lower flexion angle was correlated with higher component migration.
METHODS: Eighty patients (mean age = 63 years, 48 males) with medial knee osteoarthritis were randomized in three ways to CLTP (n = 25), CTP (n = 26) or CSP (n = 29) femoral UKR components. The patients were followed 5 years postoperatively with RSA, bone mineral density (BMD), PROMs and radiological evaluation of radiolucent lines (RLL), femoral component flexion angle and complications.
RESULTS: At the 5-year follow-up, femoral component total translation was comparable between the three groups (p = 0.60). Femoral component internal rotation was 0.50° (95% CI 0.3; 0.69) for the CLTP group, 0.58° (95% CI 0.38; 0.77) for the CTP group and 0.25° (95% CI 0.07; 0.43) for the CSP group (p = 0.01). BMD decreased peri-prosthetically (range - 11.5%; - 14.0%) until 6-month follow-up and increased toward the 5-year follow-up (range - 3.6%; - 5.8%). BMD change did not correlate with component migration. Lower flexion angle was correlated with higher 5-year subsidence, total translation, varus rotation and maximum total point motion (p = 0.01). Two patients (1 CLTP, 1 CTP) had RLL in the posterior zone. There were two revisions.
CONCLUSIONS: At 5-year follow-up, fixation of UKA femoral components with twin-peg was not superior to the single-peg design. Cementless and cemented twin-peg femoral components had similar fixation. A lower flexion angle was correlated with higher component migration.
摘要：
背景：关节成形术的组件设计和固定方法可能会影响组件的迁移和存活。这项研究的目的是比较无骨水泥双桩（CLTP）的固定，内侧单室膝关节置换术（UKR）的骨水泥双钉（CTP）和骨水泥单钉（CSP）股骨组件。
方法：80名患者（平均年龄=63岁，48名男性）患有内侧膝骨关节炎的患者以三种方式随机分为CLTP（n=25），CTP(n=26)或CSP(n=29)股UKR组件。患者术后5年随访RSA，骨矿物质密度（BMD），PROM和射线可透线（RLL）的放射学评估，股骨构件屈曲角度与并发症。
结果：在5年的随访中，股骨组件总平移在三组之间具有可比性(p=0.60).CLTP组股骨组件内旋为0.50°(95%CI0.3;0.69),CTP组为0.58°(95%CI0.38;0.77)，CSP组为0.25°(95%CI0.07;0.43)(p=0.01)。直到6个月随访，BMD在假体周围降低（范围-11.5％；-14.0％），并在5年随访时增加（范围-3.6％；-5.8％）。BMD变化与组件迁移无关。较低的屈曲角度与较高的5年沉降相关，总翻译，内翻旋转和最大总点运动（p=0.01）。两名患者（1名CLTP，1CTP）在后区有RLL。有两个修订。
结论：在5年的随访中，双桩固定UKA股骨组件并不优于单桩设计。无骨水泥和骨水泥双桩股骨组件的固定相似。较低的屈曲角度与较高的组件迁移相关。
方法：80名患者（平均年龄=63岁，48名男性）患有内侧膝骨关节炎的患者以三种方式随机分为CLTP（n=25），CTP(n=26)或CSP(n=29)股UKR组件。患者术后5年随访RSA，骨矿物质密度（BMD），PROM和射线可透线（RLL）的放射学评估，股骨构件屈曲角度与并发症。
结果：在5年的随访中，股骨组件总平移在三组之间具有可比性(p=0.60).CLTP组股骨组件内旋为0.50°(95%CI0.3;0.69),CTP组为0.58°(95%CI0.38;0.77)，CSP组为0.25°(95%CI0.07;0.43)(p=0.01)。直到6个月随访，BMD在假体周围降低（范围-11.5％；-14.0％），并在5年随访时增加（范围-3.6％；-5.8％）。BMD变化与组件迁移无关。较低的屈曲角度与较高的5年沉降相关，总翻译，内翻旋转和最大总点运动（p=0.01）。两名患者（1名CLTP，1CTP）在后区有RLL。有两个修订。
结论：在5年的随访中，双桩固定UKA股骨组件并不优于单桩设计。无骨水泥和骨水泥双桩股骨组件的固定相似。较低的屈曲角度与较高的组件迁移相关。
