中国人外侧单髁置换术假体型号的相关研究

Correlative research on the sizes of lateral unicondylar knee replacement components in Chinese patients

目的通过对中国人外侧单髁置换术(UKA)假体尺寸进行临床研究,为临床上选择合适的外侧UKA假体提供指导。方法回顾性分析2015年6月至2020年3月同济大学附属杨浦医院进行外侧UKA治疗的241例的患者资料,对其年龄、性别、左右膝、身高、体重指数(BMI)与胫骨、股骨假体型号大小进行单因素分析,从而明确中国人外侧UKA假体相关参数的分布情况。结果胫骨假体分布情况:小号占8.7%,中号占60.6%,大号占30.7%。股骨假体分布情况:小号占26.1%,中号占57.3%,大号占16.6%。年龄、左右膝、BMI与胫骨及股骨假体大小并无相关性(P>0.05),身高及性别与胫骨及股骨假体型号有明显的相关性(P<0.05)。术前通过性别结合身高这一标准,胫骨假体选择的准确率为75.9%,股骨假体选择的准确率为64.7%,根据胫骨假体来判断股骨假体的准确率为62.2%。结论中国人的外侧UKA术前根据身高结合性别能够较为准确地选择胫骨假体及股骨假体型号。然而临床上需要进一步积累病例数,以建立更适合的参考标准。

Objective To provide clinical guidance for the selection of a suitable lateral unicompartmental knee arthroplasty(UKA)component through clinical research on the sizes of such components actually used in Chinese patients.Methods This was a retrospective analysis of the data from 241 patients who underwent lateral UKA treatment using common devices(LINK Orthopaedics China Co.,Ltd.,Beijing,P.R.China)from June 2015 to March 2020 in Yangpu Hospital Affiliated to Tongji University.The distribution of component size was studied and the optimal match of tibial-femoral component was identified.The relationship between demographic data,such as age,gender,left or right knee,height,body mass index(BMI)and implanted tibia and femoral component size were analyized by Logistic single regression.Results The distribution of tibial component size was:Small 8.7%,medium 60.6%,and large 30.7%.The distribution of femoral prosthesis size was:Small 26.1%,medium 57.3%,and large 16.6%.Age,laterality and BMI had no significant correlations with tibial or femoral component sizes(P>0.05),whereas height and gender did(P<0.05).The success rate for selecting the tibial component accurately before surgery was 75.9%,that for the femoral component was 64.7%,and that for the femoral one based on the tibial component was 62.2%.Conclusion Using these data,surgeons treating Chinese patients undergoing lateral UKA can choose tibial and femoral component sizes before surgery more accurately based on height and gender.However,there is a need for more cases to establish a more suitable reference standard.