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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Measuring Appropriate Need for Unicompartmental Knee Arthroplasty: Results of the MANUKA study
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Measuring Appropriate Need for Unicompartmental Knee Arthroplasty: Results of the MANUKA study

机译：测量适当的膝关节关节置换术：麦卢卡研究的结果

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Purpose: Indications for unicompartmental knee arthroplasty (UKA) are controversial. Studies based solely on radiographic criteria suggest up to 49% of patients with knee osteoarthritis (OA) are suitable for UKA. In contrast, the ‘Appropriate use criteria’ (AUC), developed by the AAOS, apply clinical and radiographic criteria to guide surgical treatment of knee OA. The aim of this study was to analyse patient suitability for TKA, UKA and osteotomy using both radiographic criteria and AUC in a cohort of 300 consecutive knee OA patients. Methods: Included were consecutive patients with clinical and radiographic signs of knee OA referred to a specialist clinic. We collected demographic data, radiographic wear patterns and clinical findings that were analyzed using the AUC. We compared the radiographic wear patterns with the treatment suggested by the AUC as well as the Surgeon Treatment Decision. Results: There were 397 knees in 300 patients available for analysis. Median age was 68 [IQR 15], BMI 30 [6] with 55% females. We found excellent consistency for both the radiographic criteria and the AUC criteria. Based on radiological criteria, 41% of knees were suitable for UKA. However, when using the AUC criteria, UKA was the appropriate treatment in only 13.3% of knees. In 19.1% of knees, no surgical treatment was appropriate at the visit, based on the collected data. Conclusion: Application of isolated radiologic criteria in patients with knee OA results in a UKA candidacy is misleadingly high. AUC that are based on both radiological and clinical criteria suggest UKA is appropriate in less than 15% of patients.
机译：目的：单位膝关节形成术（UKA）的迹象是有争议的。完全基于射线照相标准的研究表明，49％的膝关节骨关节炎（OA）适用于UKA。相比之下，由AAOS开发的“适当的使用标准”（AUC）应用临床和射线照相标准来引导膝关节OA的手术治疗。本研究的目的是利用300次连续膝关节OA患者的群组中的颈部标准和AUC分析TKA，UKA和截骨术的患者适合性。方法：包括膝关节OA的临床和放射线迹象的连续患者提到专科诊所。我们通过AUC收集了人口统计数据，射线照相磨损模式和临床调查结果。我们将射线照相磨损模式与AUC建议的治疗进行比较，以及外科医生治疗决策。结果：300名患者可用于分析397名膝盖。中位年龄是68 [IQR 15]，BMI 30 [6]，女性55％。我们发现射线照相标准和AUC标准的良好一致性。基于放射性标准，41％的膝盖适合UKA。但是，在使用AUC标准时，UKA仅适用于13.3％的膝盖。在19.1％的膝盖中，根据收集的数据，在访问中没有手术治疗。结论：在UKA候选中患者膝关节患者患者的孤立放射学标准的应用误导性高。基于放射学和临床标准的AUC建议UKA在不到15％的患者中适用。

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