Excellent outcomes for lateral unicompartmental knee arthroplasty: Multicenter 268-case series at 5 to 23 years’ follow-up

ABSTRACT Objective: To evaluate clinically and radiologically the long-term follow-up of patients with anteromedial osteoarthritis who underwent unicompartmental knee arthroplasty surgery. Methods: This study included 36 patients who underwent unicompartmental knee arthroplasty surgery for medial compartmental osteoarthritis with a minimum of 15-year post-operative follow-up. All surgeries were performed by a single surgeon (G.L.C) using the Miller-Galante unicompartmental knee implant. Patients were analyzed regarding their clinical functional and implant radiographic conditions. Results: From the 46 patients who could have completed 15 years of follow-up, three required revision surgery with conversion to total knee arthroplasty (6.5%), 36 completed the 15-year follow-up period, and the others were lost to follow-up for reasons not related to unicompartmental arthroplasty. Conclusion: In these 36 patients, the result was satisfactory after follow-up, with complaints and sign of progression of osteoarthritis in some cases. Level of Evidence IV, Case series.

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A Key Technique for Lateral Unicompartmental Knee Arthroplasty and Its Clinical Efficacy

10.21203/rs.3.rs-129861/v1 ◽

2020 ◽

Author(s):

Tao Wen ◽

Ming Hua Xue ◽

Tong Ma ◽

Tao Yang ◽

Long Xue ◽

...

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Surgical Techniques ◽

Lateral Compartment ◽

Valgus Deformity ◽

Surgical Instruments ◽

Unicompartmental Knee ◽

Lateral Unicompartmental Knee Arthroplasty ◽

Initial Symptoms

Abstract Background: Currently, the surgical technique and design of surgical instruments for lateral unicompartmental knee arthroplasty (UKA) in treating lateral knee compartment-specific anatomical structures cannot be replicated. Moreover, few articles have reported on the surgical techniques and clinical effects.These have caused most joint surgeons to dare not to carry out this operationinChina.Here, we report on how we perform this procedure in a replicable manner using redesigned tools, and evaluate subsequent American Knee Society scores, range of motion (ROM), and revision rates.Methods: In this retrospective review (January 2014 through January 2016) we identified 158 patients (35 males and 123 females) who had 160 lateral unicompartmental arthroplasties with a minimum of 36 months follow-up (mean 54, range 36–60 months). The initial symptoms of painful osteoarthritis or osteonecrosis were localized to the lateral compartment. The standard of X-slices is mainly limited to the lateral compartment (Ahlbäck grade II OA or worse) while the articular cartilage of the medial compartment shows no obvious clinical or imaging signs of wear. Any valgus deformity must be correctable to reduce varus stress, and any form of inflammatory arthritis is an absolute contra-indication for lateral UKA.Results: At follow-up, American Knee Society scores (0–100 points) averaged 47.3 ± 1.5 for pain, 97.0 ± 1.7 for clinical outcome, and 97.1 ± 4.1 for function, and ROM averaged 125.5 ± 5.3°. None of the patients had reoperations or revisions.Conclusion: These standard surgical techniques and tools are useful to beginners because they can effectively avoid impingement of the femur against the tibial spine eminences and provide good results.

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FACTORS AFFECTING THE FUNCTIONAL OUTCOME OF OXFORD PHASE 3 UNICOMPARTMENTAL KNEE ARTHROPLASTY

Acta Ortopédica Brasileira ◽

10.1590/1413-785220202802225137 ◽

2020 ◽

Vol 28 (2) ◽

pp. 78-83

Author(s):

AYŞE ESIN POLAT ◽

BARIŞ POLAT ◽

TAHSIN GÜRPINAR ◽

BARIŞ PEKER ◽

TOLGA TÜZÜNER

Keyword(s):

Functional Outcome ◽

Knee Arthroplasty ◽

Revision Surgery ◽

Unicompartmental Knee Arthroplasty ◽

Case Series ◽

Morbidly Obese ◽

Phase 3 ◽

Radiological Criteria ◽

Unicompartmental Knee

ABSTRACT Objective: To determine the factors that affect the functional outcome of Oxford Phase 3 unicompartmental knee arthroplasty (UKA). Methods: We assessed a total of 52 UKA knees of 49 patients with a minimum follow-up of 2 years (24-72 months). We recorded the results for Range of motion (ROM) and body mass index (BMI) and the presence o patello-femoral arthrosis (PFA). In the radiological evaluation, we measured the posterior tibial slope (PTS), the tibial plateau angle (TPA) and the femorotibial angle, in addition to an assement using the Oxford radiological criteria. Patients were grouped by age, follow-up time, BMI, radiological criteria, PFA presence, occurance of complications and revision surgery. The clinical and functional results of these groups were compared statistically. Results: A total of 40 women and 9 men participated in the study, with an average age of 60 years, and a mean BMI of 34.6. No significant differences were found among the age and PFA groups. Postop VAS scores were high and knee evaluation scores were significantly lower in the morbidly obese group and in the groups with postop TPA <85º and >90º. The revision ratio was 11.5%. Conclusion: Postop TPA, PTS and morbid obesity are the most significant factors that can lead to revision surgery. Level of Evidence IV, Case series.

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Return to Sports after Unicompartmental Knee Arthroplasty: Reality or Utopia? A 48-Month Follow-Up Prospective Study

The Journal of Knee Surgery ◽

10.1055/s-0038-1635111 ◽

2018 ◽

Vol 32 (02) ◽

pp. 186-191 ◽

Cited By ~ 1

Author(s):

Mirco Lo Presti ◽

Sergio Cialdella ◽

Giuseppe Agrò ◽

Alberto Grassi ◽

Silvio Caravelli ◽

...

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Polyethylene Wear ◽

Young Patients ◽

Case Series ◽

High Impact ◽

Return To Sports ◽

Unicompartmental Knee ◽

Early Loosening

AbstractUnicompartmental knee arthroplasty (UKA) has increased in popularity in the last years, also in younger and more active patients with great expectancies. The purpose of our study was to investigate the change in sports activities before and after medial UKA. We surveyed 53 athletic patients; all underwent cemented medial UKA, to determine not only their subjective and objective evaluation of clinical status with Hospital for Special Surgery (HSS) and visual analog score (VAS) score, but also their sporting and recreational activities at a mean follow-up of 48 ± 6 months (range, 18–56 months). At the last follow-up, 48 of 53 patients were engaged in sports and recreational disciplines, resulting in a return to activity rate of 90%. No early failure and no cases of revision were reported. The frequency of activities (sessions per week) and the time session remained constant at the time of survey. The most common activities after surgery were hiking, cycling, and swimming. Several high-impact activities, as well as skiing and football, had a significant decrease in participating patients. There were no gender-, age- and body mass index (BMI)-related differences. UKA can be considered a viable alternative in relatively young patients with high functional requirements and the correct indications, however, warning the patients about the risks of polyethylene wear and early loosening of the prosthetic components as a result of the resumption of sporting activities in high impact. Level of Evidence Prospective case series, level 4.

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Predictors of Satisfactory Outcomes With Fixed-Bearing Lateral Unicompartmental Knee Arthroplasty: Up to 7-year Follow-Up

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.10.001 ◽

2020 ◽

Author(s):

Huaming Xue ◽

Tong Ma ◽

Tao Wen ◽

Tao Yang ◽

Long Xue ◽

...

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Fixed Bearing ◽

Unicompartmental Knee ◽

Lateral Unicompartmental Knee Arthroplasty

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Survival of Lateral Unicompartmental Knee Arthroplasty in Short-to-long-term Follow-ups: Meta-analysis

10.21203/rs.3.rs-669692/v1 ◽

2021 ◽

Author(s):

Zhao Guo ◽

Ligang Qian ◽

Wenshan Gao ◽

Yunfei Wang ◽

Fei Gao ◽

...

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Meta Analysis ◽

Primary Treatment ◽

Unicompartmental Knee ◽

Lateral Unicompartmental Knee Arthroplasty ◽

Long Term Follow Up ◽

Lateral Uka

Abstract BackgroundThe effectiveness of unicompartmental knee arthroplasty by lateral UKA remains poorly characterized as a limit of lateral UKA were operated for osteoarthritis (OA). However, the field of UKA surgery has rapidly expanded the usage of partly knee replacement in KOA patients with increased satisfaction, survivorship and functional outcomes. Methods A meta-analysis was conducted to evaluate the survivorship of lateral UKA with assessment with short-to midterm (<10years) and long-term (>10years) follow-up. Five databases were searched for eligible studies with search terms modified to the instructions of different databases. Twenty-three studies met the inclusion criteria and the pooling data were summarized in forest plots.ResultsThe implant survivorship of lateral UKA in short-term (3 year) was 96% (95%CI, 0.95-0.97, P<0.001), mid-term (5 year) 95% (0.93-0.96, P<0.001), long-term (10 year) 89% (0.85-0.93, P<0.001), and 15 year (85.5%, 0.79-0.92, P<0.001). Sensitivity and subgroup analysis was conducted for potential source of heterogeneity. ConclusionLateral UKA is a promising method of 90% survivorship over a short- to long-term follow up. Lateral UKA is a viable option in primary treatment of OA.

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Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06665-x ◽

2021 ◽

Author(s):

D. M. Moore ◽

G. A. Sheridan ◽

A. Welch-Phillips ◽

J. M. O’Byrne ◽

P. Kenny

Keyword(s):

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Womac Score ◽

Long Term Results ◽

Secondary Outcome ◽

Osteoarthritis Of The Knee ◽

Phase 3 ◽

Unicompartmental Knee ◽

Aseptic Revision

Abstract Purpose Unicompartmental knee arthroplasty (UKA) provides patients with an alternative treatment to TKA in isolated medial compartment osteoarthritis providing better functional outcomes and faster recovery in the short term. Our aim was to quantify revision rates, predictors of revision, mortality rate and functionality of the Oxford Phase 3 UKA in a non-designer institution. Methods This was a retrospective review of prospectively collected regional registry data. All Oxford Phase 3 UKAs performed for medial tibio-femoral osteoarthritis of the knee joint were included from a single academic institution between the period of January 1st 2006 and December 30th 2009. Kaplan-Meier survivorship curves adjusting for loss to follow-up and deceased patients were generated. Primary outcome variables included all-cause and aseptic revision. Secondary outcome variables included functional outcome scores. Patients were reviewed at 6 months, 2 years, 5 years, 10 years and 15 years. Results A total of 64 cemented Oxford phase 3 UKAs were performed between January 2006 and November 2009. Fifteen-year follow-up data were available for 51 patients, of these 12 required revision. Survival rates, adjusting for patients that were either lost to follow-up or deceased, were 87.5% at 5 years, 81.4% at 10 years and 76.4% at 15 years. The overall aseptic revision rate at the time of review was 18.75% (n = 12). The only significant predictor of postoperative WOMAC score at 15 years was the preoperative WOMAC score (p = 0.03). Conclusion The Oxford Phase 3 UKA for medial tibio-femoral arthritis has promising outcomes at 15-year follow-up with a survival rate of 76.4% in a non-designer centre. Level of Evidence III.

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