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Ly L, Batailler C, Shatrov J, Servien E, Lustig S. Satisfactory Outcomes of All-Poly Fixed Bearing Unicompartmental Knee Arthroplasty for Avascular Osteonecrosis Versus Osteoarthritis: A Comparative Study With 10 to 22 Years of Follow-up. J Arthroplasty 2022; 37:1743-1750. [PMID: 35398224 DOI: 10.1016/j.arth.2022.03.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND While good mid-term results for treating spontaneous knee osteonecrosis (SPONK) with unicompartmental knee arthroplasty (UKA) have been reported, concerns remain about implant survival at long-term. This study aimed to compare outcomes and survivorship of UKA for SPONK vs osteoarthritis at a minimum of 10 years. METHODS This case-control study included medial UKA for femoral SPONK operated between 1996 and 2010 with a minimum 10-year follow-up (n = 47). Each case was matched with a medial UKA for osteoarthritis based on body mass index (BMI), gender, and age. Knee Society Score (KSS), complications and radiological (loosening) data were collected at the last follow-up. Kaplan-Meier survivorship analysis was performed using revision implant removal as endpoint. RESULTS The mean follow-up was 13.2 years (range 10 to 21 years). Mean age and BMI were 72.9 ± 8.4 years and 25.5 ± 3.6 Kg/m2 in SPONK group. At last follow-up, knee and function KSS were 89.5 ± 12 and 79 ± 18 in SPONK group vs 90 ± 15 (P = .85) and 81.7 ± 17 (P = .47) in control group. Complications and radiological results showed no significant differences. The survival rate free from any revision was 85.1% at last follow-up in SPONK group and 93.6% in control group (P = .23). The leading cause for revision was aseptic tibial loosening (57.1%) in SPONK group. The 15-year survival estimate was 83% in SPONK group. CONCLUSION Satisfactory clinical outcomes at long-term after UKA for femoral SPONK were observed, similar to those after UKA for osteoarthritis, despite a higher risk of tibial loosening in the SPONK group. No symptomatic femoral loosening leading to a revision was observed. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Lyliane Ly
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France
| | - Cécile Batailler
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France; University Lyon, Claude Bernard Lyon 1 University, IFSTTAR, Lyon, France
| | - Jobe Shatrov
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France; Sydney Orthopaedic Research Institute, University of Notre Dame Australia, Hornsby and Ku-Ring Hospital, Sydney, Australia
| | - Elvire Servien
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France; LIBM - EA 7424, Interuniversity Laboratory of Biology of Mobility, Claude Bernard Lyon 1 University, Lyon, France
| | - Sébastien Lustig
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France; University Lyon, Claude Bernard Lyon 1 University, IFSTTAR, Lyon, France
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Porteous AJ, Smith JRA, Bray R, Robinson JR, White P, Murray JRD. St Georg Sled medial unicompartmental arthroplasty: survivorship analysis and function at 20 years follow up. Knee Surg Sports Traumatol Arthrosc 2022; 30:800-808. [PMID: 33502571 DOI: 10.1007/s00167-021-06454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/11/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The peri-operative and short-term benefits of unicompartmental knee arthroplasty (UKA) are well supported in the literature. However, there remains concern regarding the higher revision rate when compared with total knee replacement. This manuscript reports the functional outcome and survivorship of a large series of fixed bearing, medial unicompartmental replacements (St Georg Sled), with a minimum of 20 years follow-up. METHODS Between 1974 and 1994, 399 patients (496 knees) underwent a medial fixed-bearing UKA. Prospective data were collected pre-operatively and at regular intervals post-operatively using the Bristol Knee Score (BKS), Oxford Knee (OKS) and Western Ontario MacMaster (WOMAC) scores. Kaplan-Meier survival analysis was used to determine survivorship, with revision or need for revision as end point, and differences assessed using Mantel-Cox log rank test. RESULTS Functional knee scores improved post-operatively, but demonstrated a slight decline from 10 years of follow-up onwards. Survivorship is estimated as 86% at 10 years, 80% at 15 years, and 78% at 20 years. Sixty knees were revised, with progression of disease in another compartment the commonest reason. Eighty eight percent were revised using a primary prosthesis. For patients over the age of 65 years at the time of index procedure, 93% died with a functioning prosthesis in situ. CONCLUSION Medial UKA demonstrates good long-term function and survivorship, and represents an excellent surgical option for patients aged over 65 years of age, where few patients will require a revision procedure. LEVEL OF EVIDENCE IV.
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Affiliation(s)
| | - James R A Smith
- Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, UK.
| | - Rachel Bray
- Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, UK
| | - James R Robinson
- Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Paul White
- University of the West of England, Bristol, BS16 1QL, UK
| | - James R D Murray
- Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, UK
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Gagliardi M, Zambianchi F, Franz A, Digennaro V, Catani F. All-Polyethylene Tibial Component Does Not Affect Survivorship of Medial Unicompartmental Knee Arthroplasty at Mid-Term Follow-Up. J Knee Surg 2021; 34:1454-1462. [PMID: 32450602 DOI: 10.1055/s-0040-1710360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The present study's primary aim was to determine the survivorship of a large cohort of patients implanted with a single design all-polyethylene tibial component medial unicompartmental knee arthroplasty (UKA). Its secondary purpose was to investigate the reasons underlying implant failure, with specific attention to component positioning and limb alignment. Between 2007 and 2013, 166 patients underwent medial UKA with a single design all-polyethylene tibial component at two centers. Preoperatively and postoperatively, patients were administered clinical outcome scores and radiographic information were collected. Postoperative complications and causes of revision were recorded. A total of 140 patients (80 in Center A and 60 in Center B) who underwent all-polyethylene tibial component medial UKA (82 cases in Center A and 60 in Center B) were taken into account. Kaplan-Meier cumulative survivorship of implants was 96.5% (confidence interval [CI]: 91.7-98.6%) at an average follow-up of 61.1 months. Tibial aseptic loosening was accounted for failure in one case, while no correlation was found between implant positioning and failure. Two revisions were performed in Center A and three in Center B. Slight correction of the preoperative varus deformity was performed at both centers. All-polyethylene tibial component UKA provided satisfactory clinical and functional outcome, with excellent survival rate in the early and mid-term follow-up. Continued patient follow-up is needed to determine long-term survivorship of the examined UKA model.
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Affiliation(s)
- Michele Gagliardi
- Department of Orthopaedic Surgery, Università degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Francesco Zambianchi
- Department of Orthopaedic Surgery, Università degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Alois Franz
- Department of Orthopedic Surgery and Sports Traumatology, St. Marien-Krankenhaus - Siegen, Germany
| | - Vitantonio Digennaro
- 1st Orthopedic Clinic, Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy
| | - Fabio Catani
- Department of Orthopaedic Surgery, Università degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
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Murray JRD, Smith JRA, Bray R, Robinson JR, White P, Porteous AJ. Fixed bearing, all-polyethylene tibia, lateral unicompartmental arthroplasty - A final outcome study with up to 28 year follow-up of a single implant. Knee 2021; 29:101-109. [PMID: 33610116 DOI: 10.1016/j.knee.2020.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 12/15/2020] [Accepted: 12/26/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lateral unicompartmental arthroplasty (UKA) constitutes only 5-10% of all unicompartmental replacements performed. Whilst the short and medium term benefits are well documented, there remains concern regarding the higher revision rate when compared with total knee replacement. We report the long term clinical outcome and survivorship of a large series of lateral UKA. PATIENTS AND METHODS Between 1974 and 1994, 71 patients (82 knees) underwent a lateral fixed-bearing St Georg Sled UKA. Prospective data was collected pre-operatively and at regular intervals post-operatively using the Bristol Knee Score (BKS), with later introduction of the Oxford Knee (OKS) and Western Ontario MacMaster (WOMAC) scores. Kaplan Meier survival analysis was used, with revision, or need for revision, as end point. 85% of the patients were female. No patients were lost to follow-up. RESULTS Functional knee scores improved post-operatively up to 10 years, at which point they demonstrated a steady decline. Survivorship was 72% at 15 years, and 68% at 20 and 25 years. Nineteen knees were revised, with progression of disease in another compartment the commonest reason. There were two revisions due to implant fracture. In patients aged over 70 years at time of index procedure, 81% died with a functioning prosthesis in situ. CONCLUSION This represents the longest follow-up of a large series of lateral UKA. Results of this early design of fixed bearing UKA demonstrate satisfactory long term survivorship. In elderly patients, further intervention is rarely required. More contemporary designs or techniques may show improved long term survivorship in time.
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Affiliation(s)
- James R D Murray
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
| | - James R A Smith
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
| | - Rachel Bray
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
| | - James R Robinson
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
| | - Paul White
- University of the West of England, Bristol BS16 1QL, United Kingdom.
| | - Andrew J Porteous
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom.
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Bruce DJ, Hassaballa M, Robinson JR, Porteous AJ, Murray JR, Newman JH. Minimum 10-year outcomes of a fixed bearing all-polyethylene unicompartmental knee arthroplasty used to treat medial osteoarthritis. Knee 2020; 27:1018-1027. [PMID: 32220535 DOI: 10.1016/j.knee.2020.02.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/03/2020] [Accepted: 02/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Unicompartmental knee arthroplasty (UKA) accounts for 8.9% of knee arthroplasty procedures in England, Wales and Northern Ireland. Fixed bearing UKA designs have shown favourable survivorship in registries when compared with mobile bearings but some studies suggest poor survival of all-polyethylene fixed tibial bearings. This study analyses long-term follow-up of patients with a medial fixed all-polyethylene tibial bearing UKA and reports survivorship and 10-year clinical outcomes. METHODS Data was collected prospectively for 214 medial unicompartmental all-polyethylene tibial bearing UKAs implanted in 184 patients at our tertiary referral centre between November 2002 and December 2007. The indication was osteoarthritis in all but one patient. Patient reported outcome scores were documented pre-operatively and at five, eight, 10 and 12 years of follow-up. The mean patient age was 70 years (range 41-87). RESULTS Outcome and survivorship data were collected for 214 medial all-polyethylene tibial bearing UKAs. There were outcomes recorded for 83 UKAs with at least 10-year follow-up. Twenty-four patients underwent revision of their UKA at an average of 5.84 years after the primary procedure. Kaplan-Meier analysis demonstrated survivorship of 89.1% at 10 years and the OKS, AKSS and WOMAC patient reported outcomes remained significantly improved in comparison to preoperatively. For those 70 years or older, 10-year survivorship was 92.4%, compared to 85.0% for those under 70 years old. CONCLUSION Medial fixed all-polyethylene tibial bearing UKA demonstrates acceptable long-term survivorship and patient outcomes. It appears to be a suitable option for the treatment of medial compartment OA, particularly in older patients.
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Affiliation(s)
- David J Bruce
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
| | - Mohammed Hassaballa
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - James R Robinson
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Andrew J Porteous
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
| | - James R Murray
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
| | - John H Newman
- Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
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Lösungen für häufige Komplikationen bei Teilprothetik. ARTHROSKOPIE 2019. [DOI: 10.1007/s00142-019-00300-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gaudiani MA, Nwachukwu BU, Baviskar JV, Sharma M, Ranawat AS. Optimization of sagittal and coronal planes with robotic-assisted unicompartmental knee arthroplasty. Knee 2017; 24:837-843. [PMID: 28579132 DOI: 10.1016/j.knee.2017.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/24/2017] [Accepted: 05/02/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND One of the anatomic goals of total knee arthroplasty (TKA) is optimizing in the coronal and sagittal plane. Accurate alignments of both planes have been correlated to functional outcome and range of motion. There is a paucity of evidence on the accuracy of unicompartmental knee arthroplasty (UKA) in balancing biplanar knee alignment - specifically sagittal plane alignment. Because robotic assisted UKA has an advantage of more accurately manipulating sagittal plane for optimal alignment and kinematics based on pre-operative and intraoperative CT planning we assessed the accuracy. METHODS We reviewed the clinical and radiographic information of 94 robotic assisted UKA surgeries for balancing of sagittal and coronal knee anatomy using radiographic parameters, such as posterior condylar offset ratio (PCOR), posterior tibial slope (PTS), femoral-tibial angle, and joint line. RESULTS In the sagittal plane, we found no significant difference between pre and postoperative PCOR values. As planned, PTS was significantly lower after UKA compared to the native knee (4.91° vs 2.28°; p<0.0001). In the coronal plane, there was no significant difference in the joint line however pre and post-operative mechanical axis were significantly different (5.43°±2.58 of varus vs. 2.76°±2.14 of varus; p<0.0001). CONCLUSION This study attempts to quantify sagittal and coronal plane alignment after robotic assisted UKA. More attention should be paid to the role of sagittal plane alignment after UKA. We believe modifying posterior tibial slope, while maintaining PCOR is fundamental in achieving native kinematics and optimizing range of motion in the sagittal plane. This may be best-accomplished using robotic techniques for UKA.
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Affiliation(s)
- Michael A Gaudiani
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
| | - Benedict U Nwachukwu
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Jayesh V Baviskar
- Department of Orthopedic Surgery, Topiwala National Medical College & BYL Nair Charitable Hospital, Mumbai, India
| | - Mrinal Sharma
- Department of Orthopedic Surgery, BLK Superspeciality Hospital, New Delhi, India
| | - Anil S Ranawat
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
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9
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Pandit H, Mancuso F, Jenkins C, Jackson WFM, Price AJ, Dodd CAF, Murray DW. Lateral unicompartmental knee replacement for the treatment of arthritis progression after medial unicompartmental replacement. Knee Surg Sports Traumatol Arthrosc 2017; 25:669-674. [PMID: 27017212 DOI: 10.1007/s00167-016-4075-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/01/2016] [Indexed: 01/14/2023]
Abstract
PURPOSE Lateral progression of arthritis following medial unicompartmental knee arthroplasty (UKA), although infrequent, is still the most common reason for revision surgery. Treatment options normally include conversion to total knee arthroplasty. An alternative strategy for some patients may be addition of a lateral UKA. We report the first results of staged bi-compartmental UKA (Bi-UKA) strategy. METHODS We retrospectively selected from our UKA database patients who underwent a lateral UKA to treat a symptomatic lateral osteoarthritis progression after a medial UKA. The analysis included a clinical and radiological assessment of each patient. RESULTS Twenty-five patients for a total of 27 knees of staged Bi-UKA were carried out in a single centre. The mean time interval between primary medial UKA and the subsequent lateral UKA was 8.1 years (SD ± 4.6 years). The mean age at the time of the Bi-UKA was 77.1 years (SD ± 6.5 years). The median hospital stay was 3 (range 2-9 days) days, and the mean follow-up after Bi-UKA was 4 years (SD ± 1.9 years). The functional scores showed a significant improvement as compared to the pre-operative status (paired t test, p = 0.003). There were no radiological evidences of failure. None of the patients needed blood transfusion, and there was no significant complications related to the surgical procedure without further surgeries or revisions at final follow-up. CONCLUSIONS These results suggest that addition of a lateral UKA for arthritis progression following medial UKA is a good option in appropriately selected patients. LEVEL OF EVIDENCE Observational study without controls, Level IV.
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Affiliation(s)
- H Pandit
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.
| | - F Mancuso
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
- Orthopaedics and Traumatology Unit, "Santa Maria della Misericordia" University Hospital, Udine, UD, Italy
| | - C Jenkins
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - W F M Jackson
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - A J Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - C A F Dodd
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - D W Murray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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Forster-Horváth C, Artz N, Hassaballa MA, Robinson JR, Porteous AJ, Murray JR, Newman JH. Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years. Knee 2016; 23:981-986. [PMID: 27506988 DOI: 10.1016/j.knee.2016.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 05/13/2016] [Accepted: 07/18/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Medial UKA performed in England and Wales represents seven to 11% of all knee arthroplasty procedures, and is most commonly performed using mobile-bearing designs. Fixed bearing eliminates the risk of bearing dislocation, however some studies have shown higher revision rates for all-polyethylene tibial components compared to those that utilize metal-backed implants. The aim of the study is to analyse survivorship and maximum eight-year clinical outcome of medial fixed bearing, Uniglide unicompartmental knee arthroplasty performed using an all-polyethylene tibial component with a minimal invasive approach. METHODS Between 2002 and 2009, 270 medial fixed UKAs were performed in our unit. Patients were reviewed pre-operatively, five and eight years post-operatively. Clinical and radiographic reviews were carried out. Patients' outcome scores (Oxford, WOMAC and American Knee Score) were documented in our database and analysed. RESULTS Survival and clinical outcome data of 236 knees with a mean of 7.3years follow-up are reported. Every patient with less than 4.93years of follow-up underwent a revision. The patients' average age at the time of surgery was 69.5years. The American Knee Society Pain and Function scores, the Oxford Knee Score and the WOMAC score all improved significantly. The five-year survival rate was 94.1% with implant revision surgery as an end point. The estimated 10years of survival rate is 91.3%. Fourteen patients were revised before the five-year follow-up. CONCLUSION Fixed bearing Uniglide UKA with an all-polyethylene tibial component is a valuable tool in the management of a medial compartment osteoarthritis, affording good short-term survivorship. Level of evidence IV.
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Affiliation(s)
- C Forster-Horváth
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom.
| | - N Artz
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
| | - M A Hassaballa
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
| | - J R Robinson
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
| | - A J Porteous
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
| | - J R Murray
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
| | - J H Newman
- The Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, Southmead Way, Avon, Bristol BS10 5NB, United Kingdom
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van der List JP, McDonald LS, Pearle AD. Systematic review of medial versus lateral survivorship in unicompartmental knee arthroplasty. Knee 2015; 22:454-60. [PMID: 26507286 DOI: 10.1016/j.knee.2015.09.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/20/2015] [Accepted: 09/22/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Unicompartmental knee arthroplasty (UKA) has gained popularity in patients with isolated unicompartmental osteoarthritis. To our knowledge no systematic review has assessed and compared survivorship of medial and lateral UKA. We performed a systematic review assessing medial and lateral UKA survivorship and comparing survivorship in cohort studies and registry-based studies. METHODS A search was performed using PubMed, Embase and Cochrane systems. Ninety-six eligible studies reported survivorship, of which fifty-eight reported medial and sixteen reported lateral UKA survivorship. Nineteen cohort studies and seven registry-based studies reported combined medial and lateral survivorship. RESULTS The five-year, ten-year and fifteen-year medial UKA survivorship was 93.9%, 91.7% and 88.9%, respectively. Lateral UKA survivorship was 93.2%, 91.4% and 89.4% at five-year, ten-year and fifteen-year, respectively. No statistical difference between both compartments was found. At twenty years and twenty-five years survivorship of medial UKA was 84.7% and 80%, respectively, but no studies reported lateral UKA survivorship at these follow-up intervals. Survivorship of cohort studies was not significantly higher compared to registry-based studies at five years (94.3 vs. 91.7, respectively, p=0.133) but was significantly higher at ten years (90.5 vs. 84.1, p=0.015). CONCLUSION This is the first systematic review that shows no difference in the five-, ten- and fifteen-year survivorship of medial and lateral UKA. We found a lower survivorship in the registry-based studies compared to cohort studies.
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Affiliation(s)
- J P van der List
- Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E. 70th Street, New York, NY 10021, United States.
| | - L S McDonald
- Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E. 70th Street, New York, NY 10021, United States.
| | - A D Pearle
- Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 E. 70th Street, New York, NY 10021, United States.
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Parratte S, Ollivier M, Lunebourg A, Abdel MP, Argenson JN. Long-term results of compartmental arthroplasties of the knee. Bone Joint J 2015; 97-B:9-15. [DOI: 10.1302/0301-620x.97b10.36426] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Partial knee arthroplasty (PKA), either medial or lateral unicompartmental knee artroplasty (UKA) or patellofemoral arthroplasty (PFA) are a good option in suitable patients and have the advantages of reduced operative trauma, preservation of both cruciate ligaments and bone stock, and restoration of normal kinematics within the knee joint. However, questions remain concerning long-term survival. The goal of this review article was to present the long-term results of medial and lateral UKA, PFA and combined compartmental arthroplasty for multicompartmental disease. Medium- and long-term studies suggest reasonable outcomes at ten years with survival greater than 95% in UKA performed for medial osteoarthritis or osteonecrosis, and similarly for lateral UKA, particularly when fixed-bearing implants are used. Disappointing long-term outcomes have been observed with the first generation of patellofemoral implants, as well as early Bi-Uni (ie, combined medial and lateral UKA) or Bicompartmental (combined UKA and PFA) implants due to design and fixation issues. Promising short- and med-term results with the newer generations of PFAs and bicompartmental arthroplasties will require long-term confirmation. Cite this article: Bone Joint J 2015;97-B(10 Suppl A):9–15.
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Affiliation(s)
- S. Parratte
- Aix-Marseille University, IML
Hopital Sainte Marguerite, 13008, Marseille, France
| | - M. Ollivier
- Aix-Marseille University, 270
Boulevard Sainte Marguerite, BP 29, 13274
Marseille, France
| | - A. Lunebourg
- Aix-Marseille University, 270
Boulevard Sainte Marguerite, BP 29, 13274
Marseille, France
| | - M. P. Abdel
- Mayo Clinic, 200
First Street S.W., Rochester, MN
55905, USA
| | - J-N. Argenson
- Aix-Marseille University, 270
Boulevard Sainte Marguerite, BP 29, 13274
Marseille, France
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