Unicompartmental Knee Osteoarthritis: Alignment Osteotomies

2020 ◽  
pp. 63-75
Author(s):  
Carlos A. Encinas-Ullán ◽  
Primitivo Gómez-Cardero ◽  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Knee Osteoarthritis ◽  
Unicompartmental Knee

scholarly journals Complications, Reasons for Reoperation, and 5-Year Prosthesis Survival Compared Between the Cemented and Cementless Oxford Unicompartmental Knee Arthroplasty Fixation Techniques at Thailand’s Largest National Tertiary Referral Center

2021 ◽  
Author(s):  
Jirayu Paugchawee ◽  
Chaturong Pornrattanamaneewong ◽  
Pakpoom Ruangsomboon ◽  
Rapeepat Narkbunnam ◽  
Keerati Chareancholvanich
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cox Proportional Hazards Model ◽  
Implant Survival ◽  
Unicompartmental Knee ◽  
Prosthesis Survival ◽  
Significant Difference ◽  
Oxford Unicompartmental Knee Arthroplasty

Abstract Background: Oxford unicompartmental knee arthroplasty (OUKA) yields favorable outcomes in patients with medial compartmental knee osteoarthritis; however, it remains unknown whether cemented or cementless OUKA fixation delivers better outcomes in Asian population. Accordingly, this study aimed to investigate the complications, reasons for reoperation, and 5-year prosthesis survival compared between cemented and cementless OUKA in Thai patients.Methods: A total of 466 cemented and 36 cementless OUKA that were performed during 2011-2015 with a minimum follow-up of five years were included. With reoperation for any reason as the endpoint, Kaplan-Meier analysis was performed to compare 5-year implant survival between groups. Complications, reasons for reoperation, and 90-day morbidity and mortality were compared between groups. Cox proportional hazards model was used to identify independent predictors of implant survival.Results: There was no significant difference in 5-year implant survival between the cemented and cementless groups (96.4% vs. 94.4%, p=0.375). The mean implant survival time was 113.0±0.8 and 70.8±1.9 months in the cemented and cementless groups, respectively (p=0.383). The most common reason for reoperation was bearing dislocation, and only one patient had 90-day morbidity. There was no significant difference between groups for complications or reasons for reoperation. No independent predictors of implant survival were identified in multivariate analysis.Conclusions: OUKA was shown to be a safe and durable reconstructive procedure in Thai patients with medial compartmental knee osteoarthritis. There was no significant difference in implant survival between the cemented and cementless groups during the 5-year follow-up, and no independent predictors of implant survival were identified. Trial registration: Thai Clinical Trials Registry, TCTR20200427004. Registered 27 April 2020 – Retrospectively registered.

scholarly journals The Cost-Effectiveness of Surgical Treatment of Medial Unicompartmental Knee Osteoarthritis in Younger Patients

2015 ◽  
Vol 97 (10) ◽  
pp. 807-817 ◽  
Author(s):  
Joseph F. Konopka ◽  
Andreas H. Gomoll ◽  
Thomas S. Thornhill ◽  
Jeffrey N. Katz ◽  
Elena Losina
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Knee Osteoarthritis ◽  
Younger Patients ◽  
Unicompartmental Knee ◽  
The Cost

scholarly journals Efficacy and mid/long-term survivorship of mobile-bearing unicompartmental knee arthroplasty for medial compartment knee osteoarthritis combined patellofemoral joint arthritis: a prospective cohort study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038448
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Shibao Lu
Keyword(s):  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Prospective Cohort ◽  
Patellofemoral Joint ◽  
Medial Compartment ◽  
Unicompartmental Knee

IntroductionUnicompartmental knee arthroplasty (UKA) is one of the most effective surgical procedures for treating isolated medial compartment knee osteoarthritis. However, previous studies have regarded patellofemoral osteoarthritis as a contraindication for UKA. In contrast, most current research shows that damage to the articular cartilage of the patellofemoral joint, even to the extent of full-thickness cartilage loss, has no influence on the outcome of UKA.Methods and analysisStudy settings: This study is a prospective cohort study that will compare the Forgotten Joint Score and Lonner patellofemoral joint score of patients who have undergone UKA; the patients will be divided into two groups (with and without patellofemoral joint osteoarthritis (PFJOA)). Primary objective: Long-term follow-up will be used to evaluate the effect of the operation on the above-mentioned scores in both the groups. Secondary objective: We will divide the patients from the with PFJOA group into three subgroups according to the localisation of patellofemoral cartilage lesions (medial zone, lateral zone and central zone). We aim to compare knee joint scores among these groups and clarify the impact of different wear sites on clinical efficacy. We will use CT to explore the potential mechanism through which UKA affects patellofemoral joint-related parameters (lateral patellar tilt, lateral patellar shift and tibia tuberosity-trochlear groove distance). We will also record mid-term/long-term post-surgery complications.Ethics and disseminationThis study’s protocol is in accordance with the Declaration of Helsinki. This study was approved by the Ethics Committee of Xuanwu Hospital. The results of this study will be disseminated in international peer-reviewed journals.Trial registration numberChiCTR2000030310.

scholarly journals Effect of unicompartmental knee arthroplasty and high tibial osteotomy with tomofix internal fixation in the treatment of unicompartmental knee osteoarthritis

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Yingzhou Hou ◽  
Shaohua Wang ◽  
Aiguo Wang
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Internal Fixation ◽  
Range Of Motion ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Osteotomy ◽  
Unicompartmental Knee ◽  
Active Range Of Motion

Introduction: Knee osteoarthritis is a common degenerative disease in the elderly clinically. Cartilage damage, osteophyte formation, joint space narrowing and bone exposure are the main pathological changes, mainly manifested as joint cartilage degeneration [1]. Since the knee joint load of normal people is mainly conducted through the medial side of the knee joint, it is easy to cause degeneration of the medial compartment and then narrow the joint space, which leads to the medial deviation of the lower limb line and the varus deformity of the knee joint. For patients aged 55-65 years with unilateral ventricular osteoarthritis of the knee, the current surgical methods are mostly high tibial osteotomy (HTO) or unicomartmental knee arthroplasty (UKA)[2,3]. HTO always thought to improve lower limb power line to correct deformities, effectively relieve pain and improve function, is an effective method for treatment of osteoarthritis knee inside, high cut bone is typically used in younger patients and patients from physical activity, can effectively reduce the load and delay of knee joint cartilage lesion replacement time, while UKA is more suitable for old age is not active, activity, and patients needs more intense in terms of pain relief. Hypotheses: To investigate the clinical effect of unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) with tomofix internal fixation in the treatment of unicompartmental knee osteoarthritis. Methods: 60 patients with unicompartmental knee osteoarthritis and varus deformity of the knee joint were randomly divided into two groups: the UKA group (30 cases) and the HTO group (30 cases). The average follow-up time was 6 months, Scores preoperative and postoperative knee joint function, postoperative complications and postoperative pain satisfaction were compared. Results: The scores of HSS, VAS, femorotibial angle(FTA) and active range of motion(ROM) were 82.6 ± 12.9, 1.9 ± 0.8,173.2 ± 1.4,135.2 ± 1.6 in the group of unicompartmental knee arthroplasty (UKA);The scores of HSS, VAS(Visual Analogue Score), femorotibial angle(FTA) and active range of motion(ROM) after tomofix internal fixation used in the group of high tibial osteotomy (HTO)were 81.9 ± 14.3, 1.8 ± 0.9, 174.5 ± 1.8 and 121.1 ± 2.7 . There was no significant difference between the UKA group and HTO group in the scores of HSS, VAS and femorotibial angle(FTA) (P > 0.05). The active range of motion(ROM) of the HTO group was better than that of UKA group (P < 0.05). Conclusion: Both unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) with tomofix internal fixation can improve the knee joint function and symptoms in the treatment of medial compartment osteoarthritis, but the active range of motion(ROM) in HTO group is better than UKA group.

scholarly journals Comparsion of Mobile-bearing UKA and Posterior Cruciate Ligament Retaining TKA for Patients with Unicompartmental Knee Osteoarthritis:a Retrospective Cohort Study

2021 ◽  
Author(s):  
Dan Wu ◽  
Yang Li ◽  
Mingxuan Ruan ◽  
GuangWen Ma ◽  
Fei Huang
Keyword(s):  
Knee Osteoarthritis ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Mobile Bearing ◽  
Primary Treatment ◽  
Range Of Movement ◽  
Unicompartmental Knee ◽  
Osteoarthritis Patient ◽  
Posterior Cruciate Ligament Retaining

Abstract Introduction: Many studies have compared unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) for knee osteoarthritis suggesting that both procedures had good clinical outcomes. However, there have been fewer studies comparing the mobile-bearing UKA (MB-UKA) and posterior cruciate ligament retaining TKA (CR-TKA) for patients with unicompartmental knee osteoarthritis. Thus, we explored the differences in outcomes and complications between the two cohorts.Methods: In this retrospective study, 41 patients who underwent MB-UKA and 40 who underwent CR-TKA in our institution were included. All patients were suffered from unicompartmental knee osteoarthritis. Patient demographics, preoperative and latest postoperative range of movement (ROM), Knee Society (KS) scores, and Forgotten Joint Score (FJS) were compared between the two cohorts. Additionally, complications, revisions, and 5-years survivorship were also analyzed.Results: The results showed MB-UKA patients had similar preoperative ROM and Knee Society pain (KSP), functional (KSF), and clinical (KSC) scores with CR-TKA patients (p = 0.104, p = 0.755, p = 0.32, p = 0.928, respectively). The mean follow-up for MB-UKA and CR-TKA groups was 3.4 and 3.7 years, respectively. Two MB-UKA and one CR-TKA patient required revision surgery. The latest postoperative KSF scores, ROM, FJS, and change in KSC scores and ROM were higher (p < 0.05) after MB-UKA, but the latest postoperative KSP, KSC, and change in KSF scores were equivalent between the two cohorts. There were no differences in complication, revision rates, and 5-year survivorship estimates.Conclusions: MB-UKA patients showed better functional outcomes and FJS, and higher ROM with similar survivorship compared with CR-TKA patients. MB-UKA should be considered as a primary treatment option for patients with unicompartmental knee osteoarthritis.Trial registration: researchregistry5032. Registered 23 July 2019, retrospectively registered

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

2019 ◽  
Author(s):  
Corey Scholes ◽  
Milad Ebrahimi ◽  
Clarice Field ◽  
Sami Farah ◽  
Dennis Kerr ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Patient Reported Outcomes ◽  
Revision Rate ◽  
Medium Term ◽  
Clinical Patient ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Cumulative Revision Rate ◽  
Inlay Prosthesis

AbstractThere are limited medium-term outcome data available for the Repicci II device in unicompartmental knee arthroplasty (UKA). The purpose of this study was to report the medium-term (minimum 2 years) patient-reported outcomes and long-term (up to 14 years) procedure survival in a consecutive series of patients undergoing an inlay prosthesis UKA (Repicci II) at an independent orthopaedic clinic. Patients presenting with medially localized unicompartmental knee osteoarthritis and meeting the criteria appropriate for UKA were recruited to a clinical patient registry at the time of presentation. A cemented unicompartmental prosthesis (Repicci II) was implanted using minimally invasive techniques with rapid postoperative mobilization. Patients were asked to complete patient-reported outcomes preoperatively and annually postoperatively. A procedure list was cross-matched with the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and an analysis of procedure survival was performed with comparison to the national data for UKA. Data from a cohort of 661 primary medial compartment UKA procedures performed in 551 patients over a 15-year period were extracted from the clinical patient registry. Significant improvements were maintained in general health, disease symptoms, pain, and function at an average follow-up of 9 years compared with preoperative data. Threshold analysis revealed that >65% of patients exceeded Patient Acceptable Symptom State at the latest follow-up, with >80% within or exceeding age-matched norms for general health. Cumulative revision rate was significantly lower than that reported for UKA in the AOANJRR at up to 13 years follow-up. This series represents a lower cumulative revision rate than previously reported, with >65% of patients reporting satisfactory functional outcomes at an average of 9 years from surgery. Surgical options for treating unicompartmental knee osteoarthritis could include UKA as a viable alternative; however, clear definitions of procedure success and its overall cost–benefit ratio in the context of ongoing management of knee osteoarthritis remain to be elucidated.

Simultaneous bilateral unicompartmental knee arthroplasty surgery has benefits in low complication rate and cost-effectiveness: a systematic review

2020 ◽  
Vol 5 (4) ◽  
pp. 218-223
Author(s):  
Nicolas Pujol ◽  
Yoshiki Okazaki ◽  
Takayuki Furumatsu
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cost Savings ◽  
Level Of Evidence ◽  
Patient Profile ◽  
One Stage ◽  
Unicompartmental Knee

ImportanceBilateral knee osteoarthritis is frequent and the best choice of treatment remains questionable, especially when the surgeon has to consider simultaneous or staged bilateral unicompartmental knee arthroplasty (UKA).ObjectiveThe purpose of this systematic review was to conduct a systematic review assessing the clinical outcomes associated with simultaneous bilateral and staged bilateral UKA.Evidence reviewA literature search was conducted in June 2019 in Medline, PubMed and Embase. A full-text review of eligible studies was conducted by two investigators.FindingsA total of 10 retrospective studies were identified. These studies described the results of simultaneous bilateral UKA compared either to staged bilateral UKA or unilateral UKA. Results showed that the prevalence of mortality at a minimum of 30 days postoperatively, deep vein thrombosis, the rate of blood transfusion and reintervention were not higher in patients undergoing a one-stage bilateral UKA. The cost-effectiveness is in favour of doing a one-stage procedure due to the shortness of total hospital stay.Conclusions and relevanceOne-stage simultaneous bilateral UKA can be performed with preventing the postoperative complication, and result in cost savings for patients with symptomatic medial bilateral unicompartmental knee osteoarthritis. Further comparative studies are necessary to determine the best patient profile for such a surgery, and the technical considerations during surgery (consecutive surgery or simultaneous surgery with two operative teams).Level of evidenceIV.

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