BACKGROUND AND PURPOSE The main treatments for severe medial compartment knee arthritis are unicompartmental (UKR) and total knee replacement (TKR). UKRs have higher revision rates, particularly for aseptic loosening, therefore the cementless version was introduced. We compared the outcomes of matched cementless UKRs and TKRs. PATIENTS AND METHODS The National Joint Registry was linked to the English Hospital Episode Statistics and Patient Reported Outcome Measures (PROMs) databases. 10,552 cementless UKRs and 10,552 TKRs were propensity matched and regression analysis used to compare revision/reoperation risks. 6-month PROMs were compared. UKR results were stratified by surgeon caseload into low- (< 10 UKRs/year), medium- (10 to < 30 UKRs/year), and high-volume (≥ 30 UKRs/year). RESULTS 8-year cementless UKR revision survival for the 3 respective caseloads were 90% (95% CI 87-93), 93% (CI 91-95), and 96% (CI 94-97). 8-year reoperation survivals were 76% (CI 71-80), 81% (CI 78-85), and 84% (CI 82-86) respectively. For TKR the 8-year implant survivals for revision and reoperation were 96% (CI 95-97) and 81% (CI 80-83). The HRs for the 3 caseload groups compared with TKR for revision were 2.0 (CI 1.3-2.9), 2.0 (CI 1.6-2.7), and 1.0 (CI 0.8-1.3) and for reoperation were 1.2 (CI 1.0-1.4), 0.9 (CI 0.8-1.0), and 0.6 (CI 0.5-0.7). 6-month Oxford Knee Score (OKS) (39 vs. 37) and EQ-5D (0.80 vs. 0.77) were higher (p < 0.001) for the cementless UKR. INTERPRETATION Cementless UKRs have higher revision and reoperation rates than TKR for low-volume UKR surgeons, similar reoperation but higher revision rates for mid-volume surgeons, and lower reoperation and similar revision rates for high-volume surgeons. Cementless UKR also had better PROMs.

中文翻译：

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基于英格兰、威尔士、北爱尔兰和马恩岛国家关节登记处的非骨水泥单间室和全膝关节置换结果的匹配比较。

背景和目的 严重内侧间室膝关节炎的主要治疗方法是单间室 (UKR) 和全膝关节置换 (TKR)。UKR 具有更高的翻修率，尤其是在无菌松动方面，因此引入了无骨水泥版本。我们比较了匹配的非骨水泥 UKR 和 TKR 的结果。患者和方法 国家联合登记处与英国医院事件统计和患者报告结果测量 (PROM) 数据库相关联。对 10,552 个非骨水泥 UKR 和 10,552 个 TKR 进行了倾向匹配，并使用回归分析来比较翻修/再手术风险。比较了 6 个月的 PROM。UKR 结果按外科医生案例量分为低（< 10 UKRs/年）、中等（10 至 < 30 UKRs/年）和高容量（≥ 30 UKRs/年）。结果 3 种不同病例的 8 年非骨水泥 UKR 翻修存活率为 90%（95% CI 87-93）、93%（CI 91-95）和 96%（CI 94-97）。8 年再次手术生存率分别为 76% (CI 71-80)、81% (CI 78-85) 和 84% (CI 82-86)。对于 TKR，翻修和再次手术的 8 年种植体存活率为 96% (CI 95-97) 和 81% (CI 80-83)。与翻修 TKR 相比，3 个病例组的 HR 分别为 2.0 (CI 1.3-2.9)、2.0 (CI 1.6-2.7) 和 1.0 (CI 0.8-1.3)，再次手术的 HR 为 1.2 (CI 1.0-1.4)、0.9 (CI 0.8-1.0)，和 0.6 (CI 0.5-0.7)。非骨水泥 UKR 的 6 个月牛津膝关节评分 (OKS)（39 对 37）和 EQ-5D（0.80 对 0.77）更高（p < 0.001）。解释 对于低手术量的 UKR 外科医生，非骨水泥 UKR 的翻修率和再手术率高于 TKR，中手术量外科医生的再次手术相似但翻修率更高，而大手术量外科医生的再次手术和翻修率相似。Cementless UKR 也有更好的舞会。