Background: 

Oxford-III unicompartmental knee replacements (UKRs) are among the most commonly used prostheses to treat isolated medial compartment osteoarthritis (OA). However, the best mode of implant fixation for primary UKRs remains a source of debate. The hypothesis of this study was that the biologically superior fixation of uncemented Oxford-III primary UKRs would translate into a lower revision rate when compared with cemented Oxford-III primary UKRs used to treat isolated medial compartment OA.

Methods: 

Data on all Oxford-III primary UKRs (n = 8,733) completed for isolated medial compartment OA from January 2000 to December 2018 were obtained from the New Zealand Joint Registry (NZJR). Revision rates were documented for each fixation type and analyzed for associations with patient sex and age at surgery. A multivariate Cox proportional-hazards analysis was completed to determine if type of fixation was an independent risk factor for revision of Oxford-III UKRs.

Results: 

Statistical analysis revealed a >1.8-fold greater revision risk for cemented Oxford-III UKRs compared with uncemented Oxford-III UKRs (p = 0.001) when considered independently of other risk factors. Furthermore, compared with uncemented fixation, cemented fixation was associated with a 2.9-fold (p < 0.001) increase in revision risk for women <65 years old and a 1.7-fold (p = 0.008) increase in revision risk for men 55 to 74 years old. There was no significant difference in the risk of revision between fixation methods for women ≥65 years old and men ≥75 years old.

Conclusions: 

We found that the type of fixation was an independent risk factor for revision of Oxford-III UKRs used in the treatment of isolated medial compartment OA. Uncemented Oxford-III primary UKRs had superior implant survivorship in women <65 years old and men 55 to 74 years old. Age and sex are important factors to consider when determining the type of fixation for Oxford-III primary UKRs used to treat isolated medial compartment OA.

Level of Evidence: 

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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骨水泥和非骨水泥牛津三期主要内侧单隔室膝关节置换术后的修订：新西兰联合注册机构的19年分析

背景： 

牛津三世的单室膝关节置换术（UKRs）是最常使用的假体，用于治疗孤立的内侧房室骨关节炎（OA）。但是，对于主要UKR的最佳植入物固定方式仍存在争议。这项研究的假设是，与用于治疗分离的内侧隔室OA的骨水泥牛津III初级UKR相比，非骨水泥牛津III初级UKR在生物学上的优越固定将转化为较低的翻修率。

方法： 

从新西兰联合登记处（NZJR）获得了2000年1月至2018年12月完成的隔离内侧舱室OA的所有牛津III级主要UKR（n = 8,733）的数据。记录每种固定类型的翻修率，并分析与手术患者性别和年龄的相关性。完成了多变量Cox比例风险分析，以确定固定类型是否是牛津III UKR修订的独立危险因素。

结果： 

统计分析显示，与其他非危险因素相比，胶结的Oxford-III UKR的修订风险比未粘合的Oxford-III UKR高1.8倍（p = 0.001）。此外，与非骨水泥固定相比，骨水泥固定与<65岁女性的修订风险增加2.9倍（p <0.001）和男性55至74岁男性的修订风险增加1.7倍（p = 0.008）。岁。对于≥65岁的女性和≥75岁的男性，固定方法之间的翻修风险没有显着差异。

结论： 

我们发现固定的类型是牛津III UKR修订版的独立危险因素，该修订版用于治疗孤立的内侧房室OA。未经胶粘的牛津三世主要UKR在＜65岁的女性和55至74岁的男性中具有较高的种植体存活率。年龄和性别是确定用于治疗孤立的内侧隔室OA的牛津III型主UKR固定类型时要考虑的重要因素。

证据级别： 

治疗级别III。有关证据水平的完整说明，请参见《作者说明》。