Mobile bearing UKA provides similar results to TKA for knee OA .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(12):22 Knee. 2012 Mar;19(2):103-6. Epub 2011 Feb 22.56 patients suffering from unicompartmental osteoarthritis were randomized to either undergo unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) to compare clinical and functional results. At an average of 52 month follow-up, UKA provided similar functional outcomes to TKA, while requiring less surgical time and fewer blood transfusions.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
2/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
Total knee arthroplasty, the current standard for treatment of knee osteoarthritis requiring replacement, may be an excessive treatment for patients suffering from only medial compartment osteoarthritis. Unicompartmental knee arthroplasty (UKA) provides theoretical advantages when compared to TKA, which include: a smaller incision size, reduced muscular dissection, less postoperative pain, less blood loss, shorter operative times,and quicker rehabilitation. These possible advantages merit an investigation comparing the results of TKA and UKA for patients with unicompartmental osteoarthritis.
Qual era la domanda di ricerca principale?
Does mobile bearing unicompartmental knee arthroplasty provide similar functional results when compared to fixed bearing total knee arthroplasty for patients with unicompartmental knee osteoarthritis, while incurring fewer related costs and risks, as evaluated over 52 months?
- Significantly less blood was lost during the UKA procedure, inferred by the change in hemoglobin (1.6g/dl (SD 0.7; Range: 0.4 to 3.0) compared to TKA 2.7g/dl (SD 1.6; Range: 0.9 to 5.8 (p=0.007)). Total postoperative drainage was significantly lesser in UKA 436 ml (SD 14; range 100 to 380) compared to 512 (SD 11; range 60 to 910) in TKA (p<0.01).
- Average operation time was 68.8 min (range: 50 to 102) in UKA compared to 81.5 min in TKA (range: 56 to 115) (p<0.01).
- Deep vein thrombosis following the operation was more prevalent in the TKA group with 7 of 56 compared to 3 of 56 (p<0.01)
- There were no differences between Knee Society scores of the two groups (80.58 (Range: 70 to 100) UKA and 78.9 (Range: 70 to 87) TKA), indicating similar functional recovery (p>0.05). There were also no differences in ROM between the two groups (UKA: 115 (SD 4) vs. TKA: 117 (SD 7); p=0.18).
- 7 UKA patients underwent conversion to TKA
Che cosa devo ricordare di più?
Unicompartmental knee arthroplasty provides similar clinical results compared to total knee arthroplasty for patients suffering from unicompartmental knee osteoarthritis. However, UKA was associated with significantly lower blood loss and operation time.
Come influenzerà l'assistenza ai miei pazienti?
The authors suggest that UKA should be considered as the primary treatment for unicompartmental knee osteoarthritis once surgeons are competent. However, this opinion is based on the assumption of reduced cost and risk, which needs to be conclusively supported using high quality RCTs.
DISCLAIMER
Il contenuto di questa pagina è solo a scopo informativo e non intende sostituire la consulenza, la diagnosi o il trattamento medico professionale. Se ha bisogno di cure mediche, si rivolga sempre al suo medico o al pronto soccorso più vicino. Le opinioni, le convinzioni e i punti di vista espressi dalle persone sui contenuti presenti in questa pagina non riflettono le opinioni, le convinzioni e i punti di vista di OrthoEvidence.
0 di 4 articoli mensili GRATUITI sbloccati
