Minimalinvasiv implantierte unikondyläre Knieendoprothese Typ Stryker-Osteonics mit metal-backed Tibiakomponente: Ein 5-Jahres-Follow-up

Zusammenfassung

Einleitung: Ziel der vorliegenden Arbeit war die Untersuchung der mittelfristigen Ergebnisse einer zementierten medialen, unikondylären Knieendoprothese mit metal-backed Tibiakomponente, implantiert in minimalinvasiver Operationstechnik. Methodik: Im Zeitraum zwischen 1997 und 1999 wurden einundneunzig mediale Knieendoprothesen vom Typ Stryker-Osteonics mit metal-backed Tibiakomponente in minimalinvasiver Technik in 91 Patienten implantiert. Präoperativ, 6 Wochen postoperativ, 1 Jahr, 3 Jahre und 5 Jahre postoperativ wurden die Patienten nach dem klinischen Kniebewertungsbogen nach Punkten (Knee-Society-Score nach Insall und Scott) untersucht. Es handelte sich um einen international anerkannten Bewertungsbogen, wobei zwischen einem klinischen Score und einem funktionellen Score unterschieden wurde (Maximalpunktzahl 100). Ergebnisse: Präoperativ betrug der durchschnittliche klinische Score 57,6 (44-66) und der funktionelle Score 63,3 (48-71). Im vorliegenden Untersuchungszeitraum kam es zu einer kontinuierlichen Verbesserung des Knee-Society-Score bei allen Patienten. Im Durchschnitt betrug bereits 1 Jahr später der klinische und funktionelle Score 94,8 (39-100) bzw. 93,6 (75-100) (p < 0,001). 5 Jahre nach Operation konnten lediglich noch 64 Patienten nachuntersucht werden, aber auch hier entsprach der Score dem der 3-Jahres-Nachuntersuchung (Knee-Score: 98,2/94-100; Function-Score: 98,9/85-100). Bei 3 Revisionsoperationen handelte es sich um eine Wechseloperation in einen zementierten, bikondylären Oberflächenersatz infolge einer Prothesenlockerung. Diskussion: Die mediale, unikondyläre Knieendoprothese vom Typ Stryker-Osteonics mit metal-backed Tibiakomponente war bei guter Indikationsstellung eine alternative Therapiemöglichkeit der medialen Gonarthrose mit ausgezeichneten klinischen Ergebnissen dar. Durch die minimalinvasive Operationstechnik wurden vergleichbar gute Ergebnisse erzielt, die den Angaben in der Literatur bezüglich der konventionellen Methode entsprechen. Zusätzlich wurde vermutlich die Rehabilitationszeit verkürzt und die Weichteiltraumatisierung vermindert.

Abstract

Introduction: The aim of this study was to evaluate the medium-term results of minimally invasive unicompartmental knee joint arthroplasty with a metal-backed tibia component. Material and Methods: Ninety-one unicompartmental knee replacements with a metal-backed tibia component, type SCR-Stryker Osteonics, were implanted in a minimally invasive technique in 91 patients between 1997 and 1999. The evaluation of medium-term results was based on The Knee Society Clinical Rating System by Insall and Scott and was done at 6 weeks, 1, 3 and 5 years after surgery. This rating system is based on the clinical and symptoms of the patient (maximum score 100). Results: Preoperatively, the average knee score was 57.6 (44-66), the function score 63.3 (48-71). Throughout the period of investigation all patients had an increased knee and function score. One year after surgery the knee and function scores increased to 94.8 (39-100) and 93.6 (75-100). Five years post-implantation only 64 patients could be re-evaluated but they also had a knee and function score corresponding to the 3-year results [knee score: 98.2 (94-100); function score: 98.9 (85-100)]. Revision surgery using a total knee prosthesis was performed in 3 cases. Discussion: The unicompartmental knee arthroplasty was a good surgical method for managing medial, unicompartmental arthritis of the knee joint. The results presented by the authors and corroborated by many literature data provide evidence that unicompartmental arthroplasty is of great importance in the treatment of unicompartmental knee arthritis. The results achieved by the minimally invasive technique of a unicompartmental knee arthroplasty with a metal-backed tibia component of the type Stryker-Osteonics were equal to the conventional surgical technique in literature. Good indications were patients older than 60 years with normal weight and normal sports activity. Well-functioning collateral and cruciate ligaments were mandatory. Moreover, the minimally invasive technique may lead to a shorter time of rehabilitation because of the reduced soft tissue damage.

Schlüsselwörter

minimalinvasiv - metal-backed - unikondyläre Knieendoprothese

Key words

Unicompartmental knee arthroplasty - minimally invasive technique - metal-backed tibia component

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