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Background <p>The success of unicompartmental knee arthroplasty (UKA) in treating end-stage knee osteoarthritis is mainly based on the surgical instruments and surgeon’s experience. The purpose of this randomized controlled trial was to compare the efficacy of patient-specific instrumentation (PSI) assisted UKA by inexperienced surgeon on the learning curve with conventional Oxford microplasty instrumentation (MPI) assisted UKA.</p> Methods <p>We performed a prospective study at a single high-volume orthopaedic hospital. Patients with end-stage medial tibiofemoral osteoarthritis were assessed for eligibility and randomly assigned to undergo either PSI-assisted UKA performed by inexperienced surgeons (PSI group) or MPI-assisted UKA performed by experienced surgeons (MPI group) at a 1:1 ratio. The primary outcome was the femoral varus/valgus angle using the mean score on the first day after surgery. The secondary outcomes included the femoral prosthesis flexion/extension angle, tibial varus/valgus angle, tibial posterior slope angle, and the hip–knee–ankle angle (HKAA). The Knee Society Score (KSS) and Hospital for Special Surgery (HSS) score were assessed at one, three, six, and 12&#xa0;months. Mixed-effects modelling was used to analyze repeated measurements.</p> Results <p>A total of 73 participants (37 in the PSI group and 36 in the MPI group) were enrolled from June 2021 to July 2023. No patients were lost to follow-up. No significant between-group differences were found in the femoral component varus and valgus angle, flexion and extension angle, tibial component varus and valgus angle, tibial posterior slope angle, or hip–knee–ankle angle (all P &gt; 0.05). At the 12-month follow-up, the PSI group and MPI group achieved mean KSSs of 93.4 points (95% CI, 88.6–97.8) and 93.6 points (95% CI, 89.1–98.4), respectively. There were no significant between-group differences in the KSS and HSS score improvements from baseline to each follow-up point.</p> Conclusions <p>The PSI-assisted UKA performed by inexperienced surgeon on a learning curve can yield excellent radiographic and functional outcomes in short-term follow-up, despite not demonstrating superior clinical outcomes to MPI-assisted UKA performed by an experienced surgeon. The PSI could potentially serve as an alternative instrumentation for UKA beginners with low-volume surgical caseload.</p>

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Patient-specific vs. Oxford microplasty instrumentation in unicompartmental knee arthroplasty: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月25日

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  • Yu Deng,
  • Xinwen Bai,
  • Zhi Zhao,
  • Linhu Cao,
  • Yang Liu,
  • Qilong Jiang

摘要

Background

The success of unicompartmental knee arthroplasty (UKA) in treating end-stage knee osteoarthritis is mainly based on the surgical instruments and surgeon’s experience. The purpose of this randomized controlled trial was to compare the efficacy of patient-specific instrumentation (PSI) assisted UKA by inexperienced surgeon on the learning curve with conventional Oxford microplasty instrumentation (MPI) assisted UKA.

Methods

We performed a prospective study at a single high-volume orthopaedic hospital. Patients with end-stage medial tibiofemoral osteoarthritis were assessed for eligibility and randomly assigned to undergo either PSI-assisted UKA performed by inexperienced surgeons (PSI group) or MPI-assisted UKA performed by experienced surgeons (MPI group) at a 1:1 ratio. The primary outcome was the femoral varus/valgus angle using the mean score on the first day after surgery. The secondary outcomes included the femoral prosthesis flexion/extension angle, tibial varus/valgus angle, tibial posterior slope angle, and the hip–knee–ankle angle (HKAA). The Knee Society Score (KSS) and Hospital for Special Surgery (HSS) score were assessed at one, three, six, and 12 months. Mixed-effects modelling was used to analyze repeated measurements.

Results

A total of 73 participants (37 in the PSI group and 36 in the MPI group) were enrolled from June 2021 to July 2023. No patients were lost to follow-up. No significant between-group differences were found in the femoral component varus and valgus angle, flexion and extension angle, tibial component varus and valgus angle, tibial posterior slope angle, or hip–knee–ankle angle (all P > 0.05). At the 12-month follow-up, the PSI group and MPI group achieved mean KSSs of 93.4 points (95% CI, 88.6–97.8) and 93.6 points (95% CI, 89.1–98.4), respectively. There were no significant between-group differences in the KSS and HSS score improvements from baseline to each follow-up point.

Conclusions

The PSI-assisted UKA performed by inexperienced surgeon on a learning curve can yield excellent radiographic and functional outcomes in short-term follow-up, despite not demonstrating superior clinical outcomes to MPI-assisted UKA performed by an experienced surgeon. The PSI could potentially serve as an alternative instrumentation for UKA beginners with low-volume surgical caseload.