PDF(Pubmed)
Abstract：
BACKGROUND: Unicompartmental knee arthroplasty (UKA) procedures are considered to be more technically demanding than conventional total knee arthroplasty (TKA), requiring a longer learning curve and more expert surgical skills. Despite some clear advantages of UKA over TKA (such as lesser blood loss, greater bone stock, greater knee performances, etc.), UKA evidenced a greater rate of revision.
OBJECTIVE: This study investigated the learning curve of Persona Partial Knee (PPK) arthroplasty for primary medial UKA performed by a single, non-designer surgeon. PPK is a fixed-bearing, compartment-specific implant. The primary outcome of interest for this study was to evaluate the learning curve of the surgical duration. The secondary outcome of interest was to evaluate the learning curve of radiological implant positioning.
METHODS: Patients who underwent primary medial UKA using PPK (Zimmer-Biomet, Warsaw IN, USA) were prospectively enrolled for the study. All surgeries were performed by a single, non-designer surgeon experienced in knee and hip arthroplasty. The primary outcome of interest was to evaluate the surgical duration. The secondary outcome of interest was to evaluate the implant positioning. The learning curve was estimated using an appropriate nonlinear polynomial regression model with a lower Akaike Information Criterion (AIC).
RESULTS: One hundred twenty five patients were enrolled in the study. 59% of them (74 of 125 patients) were women. The patients\' mean age at the time of surgery was 70.1 ± 9.5 years and their mean body mass index (BMI) was 27.8 ± 4.2 kg/m2. Curve stabilisation of the surgical time was at the 94th patient, of the tibial angle at the 47th patient, of the tibial slope at the 54th patient, of the anterior protrusion at the 29th patient, and of the posterior protrusion at the 51st patient.
CONCLUSIONS: The learning curve for component positioning was achieved in approximately 50 cases. The curve of the surgical time achieved a plateau at 94 Persona Partial Knee. Additionally, the factors directly correlated with earlier stabilization of the learning curve in terms of component positioning were: male gender, younger age, right side, and larger components.
OBJECTIVE: This study investigated the learning curve of Persona Partial Knee (PPK) arthroplasty for primary medial UKA performed by a single, non-designer surgeon. PPK is a fixed-bearing, compartment-specific implant. The primary outcome of interest for this study was to evaluate the learning curve of the surgical duration. The secondary outcome of interest was to evaluate the learning curve of radiological implant positioning.
METHODS: Patients who underwent primary medial UKA using PPK (Zimmer-Biomet, Warsaw IN, USA) were prospectively enrolled for the study. All surgeries were performed by a single, non-designer surgeon experienced in knee and hip arthroplasty. The primary outcome of interest was to evaluate the surgical duration. The secondary outcome of interest was to evaluate the implant positioning. The learning curve was estimated using an appropriate nonlinear polynomial regression model with a lower Akaike Information Criterion (AIC).
RESULTS: One hundred twenty five patients were enrolled in the study. 59% of them (74 of 125 patients) were women. The patients\' mean age at the time of surgery was 70.1 ± 9.5 years and their mean body mass index (BMI) was 27.8 ± 4.2 kg/m2. Curve stabilisation of the surgical time was at the 94th patient, of the tibial angle at the 47th patient, of the tibial slope at the 54th patient, of the anterior protrusion at the 29th patient, and of the posterior protrusion at the 51st patient.
CONCLUSIONS: The learning curve for component positioning was achieved in approximately 50 cases. The curve of the surgical time achieved a plateau at 94 Persona Partial Knee. Additionally, the factors directly correlated with earlier stabilization of the learning curve in terms of component positioning were: male gender, younger age, right side, and larger components.
摘要：
背景：单室膝关节置换术（UKA）手术被认为比传统的全膝关节置换术（TKA）技术要求更高，需要更长的学习曲线和更专业的手术技能。尽管UKA相对于TKA有一些明显的优势(比如失血少,更大的骨骼储备，更大的膝盖表现，等。),UKA证明了更高的修订率。
目的：本研究调查了由单个，非设计师外科医生.PPK是一种固定轴承，隔室特异性植入物。这项研究的主要结果是评估手术持续时间的学习曲线。感兴趣的次要结果是评估放射学植入物定位的学习曲线。
方法：使用PPK（Zimmer-Biomet，华沙,美国）被前瞻性地纳入研究。所有手术都是由一个人完成的，非设计外科医生有膝关节和髋关节置换术经验。感兴趣的主要结果是评估手术持续时间。感兴趣的次要结果是评估植入物定位。使用具有较低Akaike信息准则(AIC)的适当非线性多项式回归模型来估计学习曲线。
结果：本研究纳入了125名患者。其中59%(125例患者中的74例)是女性。患者手术时的平均年龄为70.1±9.5岁，平均体重指数（BMI）为27.8±4.2kg/m2。手术时间的曲线稳定在第94位患者，第47名患者的胫骨角，第54名患者的胫骨斜坡，第29名患者的前突起，以及第51名患者的后突起。
结论：在大约50例病例中达到了成分定位的学习曲线。手术时间曲线在94个部分膝关节处达到平稳状态。此外,在成分定位方面，与学习曲线早期稳定直接相关的因素是：男性，年龄较小,右侧,更大的组件。
目的：本研究调查了由单个，非设计师外科医生.PPK是一种固定轴承，隔室特异性植入物。这项研究的主要结果是评估手术持续时间的学习曲线。感兴趣的次要结果是评估放射学植入物定位的学习曲线。
方法：使用PPK（Zimmer-Biomet，华沙,美国）被前瞻性地纳入研究。所有手术都是由一个人完成的，非设计外科医生有膝关节和髋关节置换术经验。感兴趣的主要结果是评估手术持续时间。感兴趣的次要结果是评估植入物定位。使用具有较低Akaike信息准则(AIC)的适当非线性多项式回归模型来估计学习曲线。
结果：本研究纳入了125名患者。其中59%(125例患者中的74例)是女性。患者手术时的平均年龄为70.1±9.5岁，平均体重指数（BMI）为27.8±4.2kg/m2。手术时间的曲线稳定在第94位患者，第47名患者的胫骨角，第54名患者的胫骨斜坡，第29名患者的前突起，以及第51名患者的后突起。
结论：在大约50例病例中达到了成分定位的学习曲线。手术时间曲线在94个部分膝关节处达到平稳状态。此外,在成分定位方面，与学习曲线早期稳定直接相关的因素是：男性，年龄较小,右侧,更大的组件。
