Bearing design influences short- to mid-term survivorship, but not functional outcomes following lateral unicompartmental knee arthroplasty: a systematic review

2019 ◽  
Vol 27 (7) ◽  
pp. 2276-2288 ◽  
Author(s):  
Joost A. Burger ◽  
Laura J. Kleeblad ◽  
Inger N. Sierevelt ◽  
Wieger G. Horstmann ◽  
Peter A. Nolte
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Unicompartmental Knee ◽  
Lateral Unicompartmental Knee Arthroplasty ◽  
Bearing Design

A systematic review of robotic-assisted unicompartmental knee arthroplasty

2019 ◽  
Vol 101-B (7) ◽  
pp. 838-847 ◽  
Author(s):  
P. G. Robinson ◽  
N. D. Clement ◽  
D. Hamilton ◽  
M. J. G. Blyth ◽  
F. S. Haddad ◽  
...  
Keyword(s):  
Systematic Review ◽  
United Kingdom ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Implant Design ◽  
Current Evidence ◽  
Robotic Assisted ◽  
Implant Positioning ◽  
Unicompartmental Knee

AimsRobotic-assisted unicompartmental knee arthroplasty (UKA) promises accurate implant placement with the potential of improved survival and functional outcomes. The aim of this study was to present the current evidence for robotic-assisted UKA and describe the outcome in terms of implant positioning, range of movement (ROM), function and survival, and the types of robot and implants that are currently used.Materials and MethodsA search of PubMed and Medline was performed in October 2018 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “robotic”, “knee”, and “surgery”. The criteria for inclusion was any study describing the use of robotic UKA and reporting implant positioning, ROM, function, and survival for clinical, cadaveric, or dry bone studies.ResultsA total of 528 articles were initially identified from the databases and reference lists. Following full text screening, 38 studies that satisfied the inclusion criteria were included. In all, 20 studies reported on implant positioning, 18 on functional outcomes, 16 on survivorship, and six on ROM. The Mako (Stryker, Mahwah, New Jersey) robot was used in 32 studies (84%), the BlueBelt Navio (Blue Belt Technologies, Plymouth, Minnesota) in three (8%), the Sculptor RGA (Stanmore Implants, Borehamwood United Kingdom) in two (5%), and the Acrobot (The Acrobot Co. Ltd., London, United Kingdom) in one study (3%). The most commonly used implant was the Restoris MCK (Stryker). Nine studies (24%) did not report the implant that was used. The pooled survivorship at six years follow-up was 96%. However, when assessing survival according to implant design, survivorship of an inlay (all-polyethylene) tibial implant was 89%, whereas that of an onlay (metal-backed) implant was 97% at six years (odds ratio 3.66, 95% confidence interval 20.7 to 6.46, p < 0.001).ConclusionThere is little description of the choice of implant when reporting robotic-assisted UKA, which is essential when assessing survivorship, in the literature. Implant positioning with robotic-assisted UKA is more accurate and more reproducible than that performed manually and may offer better functional outcomes, but whether this translates into improved implant survival in the mid- to longer-term remains to be seen. Cite this article: Bone Joint J 2019;101-B:838–847.

Outcomes of Combined Unicompartmental Knee Replacement and Anterior Cruciate Ligament Reconstruction: A Systematic Review

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Timour Fekry El-Husseini ◽  
Mustafa Ali Ahmed ◽  
Yahia Ahmed Sadek
Keyword(s):  
Systematic Review ◽  
Acl Reconstruction ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Revision Rate ◽  
Unicompartmental Knee ◽  
The Mean ◽  
Acl Deficient ◽  
Deficient Knee

Abstract Background The incidence of osteoarthritis of the medial compartment after ACL injury has been quoted to range from 33% to 70%. Medial osteoarthritis in ACL deficient knee is a challenge. Patients are mainly young and active. First reports highlighted a higher incidence of complications, in terms of tibial loosening and higher revision rate, when UKA were performed in ACL-deficient knees. They defined ACL deficiency is a contraindication to UKA. Objectives A systematic review and meta-analysis of literature to assess functional outcomes of combined unicompartmental knee arthroplasty with ACL reconstruction and revision rate. Data Sources The following electronic databases were searched up to 2019: PubMed, Google Scholar search engine, JBJS {Journal of bone and joint Surgery}, Cochrane database of systematic reviews, EMBASE and Science Direct. Results A total of 10 studies met the inclusion criteria encompassing 218 patients who were treated with simultaneous ACL reconstruction and unicompartmental knee arthroplasty. The mean age was 49.5 years (range from 36 to 71) with a mean follow-up of 49.3 months (range from 9 to 258). There was an improvement in mean Oxford Score from 29 to 42.5. The mean knee society score improved from 88.3 to 159. Complications reported included tibial inlay dislocation (n = 3), conversion to a total knee arthroplasty (n = 2), infection requiring two-stage revision (n = 2), stiffness requiring manipulation under anaesthesia (n = 1). Average revision rate was 1.8%. Conclusion Literature has strong evidence to support that combined UKA and ACL reconstruction show good functional outcomes and less revision rate. It is a valid treatment option for MOA more in young age group in whom MOA secondary to ACL tear and intact other knee compartments. there is no clinical trial or study suggest that UKA and ACL reconstruction is superior to UKA with tibial slope change or using fixed bearing prosthesis for MOA in ACL deficient knee with instability.

scholarly journals High Tibial Osteotomy versus Unicompartmental Knee Arthroplasty for Compartmental Knee Osteoarthritis: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Ishith Seth ◽  
Nimish Seth ◽  
Gabriella Bulloch ◽  
Damien Gibson ◽  
Kirk Lower ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Walking Speed ◽  
Meta Analysis ◽  
Tibial Osteotomy ◽  
Unicompartmental Knee

Abstract Purpose High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are commonly performed procedures for the treatment of compartmental knee osteoarthritis. However, the optimal procedure remains controversial. Therefore, we conducted this systematic review and meta-analysis to compare the functional outcomes, complications, and revision between the two techniques.Methods We searched electronic databases for relevant studies comparing HTO versus UKA for unicompartmental knee osteoarthritis. Continuous data as visual analogue scale (VAS), range of motion, and free walking speed were pooled as mean differences (MDs). Dichotomous data as functional knee outcomes, complications, and revision were pooled as odds ratios (ORs), with 95% confidence interval (CI), using R software for windows.Results Twenty-five studies involving 8185 patients were included. Meta-analysis showed that HTO was associated with higher risk of complications (OR= 2.47, 95% CI [1.52, 4.04]), poor functional results (excellent/good) (OR= 0.32, 95% CI [0.21, 0.49]), and larger range of motion (MD= 7.05, 95% CI [2.41, 11.68]) compared to UKA. No significant differences were found between the compared groups in terms of VAS (MD= 0.14, 95% CI [-0.08, 0.36]), revision (OR= 1.30, 95% CI [0.65, 2.60]), and free walking speed (MD= -0.05, 95% CI [-0.11, 0.00]).Conclusion This study showed that UKA achieved fewer complications, better functional outcomes, and less range of motion compared to HTO. No significant differences were detected between HTO and UKA in terms of VAS and revision rate.

Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1206-1213 ◽  
Author(s):  
S. Fornell ◽  
E. Prada ◽  
P. Barrena ◽  
A. García-Mendoza ◽  
E. Borrego ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mobile Bearing ◽  
Unicompartmental Knee ◽  
Lateral Unicompartmental Knee Arthroplasty

Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes

2020 ◽  
Author(s):  
Brian Zhaojie Chin ◽  
Sharon Si Heng Tan ◽  
Kasia Chen Xi Chua ◽  
Gideon Richard Budiono ◽  
Nicholas Li-Xun Syn ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Robot Assisted ◽  
High Quality ◽  
High Quality Evidence ◽  
Unicompartmental Knee ◽  
Conventional Methods ◽  
Quality Evidence

AbstractThe study aims to provide an up-to-date systematic review and meta-analysis comparing radiological and functional outcomes of total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) using either robotic assistance or conventional methods from the latest assemblage of evidence. This study was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. All studies in PubMed, EMBASE, Medline, and Cochrane that reported radiological and functional outcomes after TKA or UKA with either robotic or conventional methods were included in the review. Selected endpoints for random effects, pairwise meta-analysis included operative details, radiological outcomes (mechanical axis, component angle deviation, and outliers), and functional outcomes (American Knee Society Score, Knee Society Function Score, revision and complication rate, range of motion (ROM), Hospital for Special Surgery score, and Western Ontario and McMaster Universities Osteoarthritis Index). A total of 23 studies comprising 2,765 knees were included from the initial search. Robot-assisted TKA and UKA were associated with significantly better component angle alignment accuracy (low-to-high quality evidence) at the cost of significantly greater operation time. Robot-assisted UKA was found to have significantly better short-term functional outcomes compared with conventional UKA (moderate-to-high quality evidence). Robot-assisted TKA, however, did not exhibit significantly better short- and midterm subjective knee outcome scores compared with its conventional counterpart (high-quality evidence). Robot-assisted TKA and UKA were associated with nonstatistically significant improved ROM and lesser rates of revision. Robot-assisted total and unicompartmental knee arthroplasty leads to better radiological outcomes, with no significant differences in mid- and long-term functional outcomes compared with conventional methods for the former. Larger prospective studies with mid- and long-term outcomes are required to further substantiate findings from the present study.

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