scholarly journals Robotic Assistance in Unicompartmental Knee Arthroplasty Results in Superior Early Functional Recovery and Is More Likely to Meet Patient Expectations

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Meredith P. Crizer ◽  
Amer Haffar ◽  
Andrew Battenberg ◽  
Mikayla McGrath ◽  
Ryan Sutton ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mixed Model ◽  
Functional Score ◽  
Robotic Assistance ◽  
Pain Scores ◽  
Unicompartmental Knee ◽  
Implant Alignment ◽  
Early Functional Recovery

Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (n = 39) or robotic methods (n = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR.), VR/SF-12, Visual Analog Scale (VAS) pain scores, and perioperative opioid consumption. Patients in the robotic cohort had superior early functional outcomes, with greater LEFS (conventional = 23; robotic = 31) at 1 week post-op p = 0.015 and KOOS-JR (conventional = 74; robotic = 81) at up to 6 months post-op p = 0.037 ; these two values remained statistically significant after mixed-model regression analysis p = 0.010 ; p = 0.023 , respectively. At 1 year post-op, expectations were more likely to be met in those who received robotic assistance p = 0.06 . No differences were reported with respect to postoperative opioid usage p = 0.320 , reoperations p = 1.00 , and complications p = 0.628 . Robotic-assisted UKA resulted in more rapid recovery and less early postoperative pain and were more likely to meet expectations than conventional UKA, although functional differences equilibrated by 1 year postoperatively. Further follow-up is necessary to determine if implant durability is impacted by robotics.

scholarly journals A Retrospective Comparison of Functional Outcomes of Robotic-Assisted and Conventional Unicompartmental Knee Arthroplasty

10.29007/8hs6 ◽  
2019 ◽  
Author(s):  
Meredith Crizer ◽  
Andrew Battenberg ◽  
Mikayla McGrath ◽  
Seong Kim ◽  
Jess Lonner
Keyword(s):  
Functional Recovery ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Preoperative Pain ◽  
Robotic Assisted ◽  
Functional Differences ◽  
Unicompartmental Knee ◽  
Retrospective Comparison ◽  
Radiographic Alignment ◽  
Early Functional Recovery

INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is effective for alleviating symptoms of arthritis in a single knee compartment; however, errors in alignment and instability may predispose to failure. Robotic technology has improved precision, but its impact on functional recovery after UKA remains unknown. The purpose of this study was to compare early functional recovery, pain, and radiographic alignment in UKA performed with either robotic assistance or conventional methods.METHODS: All consecutive patients undergoing UKA by a single physician from January 2015 to March 2018 were retrospectively reviewed. Lower Extremity Functional Scale (LEFS), KOOS Jr, and VAS (0-10) outcomes scores were collected preoperatively, 1, 6, and 12 weeks postoperatively. Radiographic alignment was assessed at the initial postoperative visit.RESULTS: There were 161 patients, 65 conventional and 96 robotic. At baseline, there was no difference in average age, BMI, or outcomes scores between the two groups. Average preoperative pain was significantly higher in conventional patients (6.1 vs. 5.4; p=0.04). At 3 weeks post-op, conventional UKA patients still had significantly higher pain levels (3.9 vs. 3.1; p=.02). Both groups showed significant improvement in LEF (p<.0001) scores over time (p<.0001). Significant improvement in KOOS Jr. scores from pre-op (52.3) to 6 and 12-weeks postoperatively (67.6, 69.8; p<0.001). When comparing PCS of the VR/SF-12, the robotic-assisted group had significantly higher improvement compared to the conventional group at 6-weeks (40.6 vs. 35.6; p=0.02).CONCLUSION: Robotic assisted UKA resulted in fewer radiographic outliers, and more rapid recovery with less early postoperative pain although functional differences tended to equilibrate by 3 months postoperatively.

Simultaneous Unicompartmental Knee Arthroplasty and Lateral Patellar Facetectomy for Bicompartmental Degenerative Disease

2013 ◽  
Vol 3 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Robert A Magnussen ◽  
Evrard Gancel ◽  
Elvire Servien ◽  
Matthias Jacobi ◽  
Guillaume Demey ◽  
...  
Keyword(s):  
Treatment Option ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Patient Population ◽  
Patellofemoral Joint ◽  
Degenerative Disease ◽  
Functional Score ◽  
Unicompartmental Knee ◽  
The Mean

ABSTRACT Introduction Unicompartmental knee arthroplasty (UKA) is a treatment option in patients with unicompartmental degenerative disease. Compared to total knee arthroplasty (TKA), the advantages of UKA include accelerated recovery and cruciate ligament retention. These advantages, along with emerging evidence that mild patellofemoral joint osteoarthritis does not compromise results of UKA have encouraged expansion of the indications for UKA. Symptomatic lateral patellofemoral joint degenerative disease is a common cause of UKA revision. Partial lateral patellar facetectomy can provide relief from symptoms of lateral patellofemoral degenerative disease. We hypothesize that simultaneous UKA and lateral patellar facetectomy provides durable pain relief and functional improvement in a patient population with degenerative disease of one tibiofemoral compartment and the lateral patellofemoral joint. Materials and methods: Between 2004 and 2008, 11 lateral UKA's were performed in association with partial lateral patellar facetectomy in 11 female patients (mean age: 66.7 years) with degenerative changes in one tibiofemoral compartment and the lateral patellofemoral joint. Patients were followed clinically and radiographically for a mean of 5 years. Results No patient underwent revision surgery in the followup period. The mean international Knee Society (IKS) knee score improved from 64.9 ± 11.2 points preoperatively to 87.5 ± 12.6 points at final follow-up (p = 0.01). The mean IKS functional score improved from 65.9 ± 23.5 points preoperatively to 83.2 ± 23.3 points at final follow-up (p = 0.012). The mean Kujala score was 84.3 ± 13.5 points postoperatively. Progression of patellofemoral OA was observed in one patient. Conclusion Simultaneous UKA and partial lateral patellar facetectomy is a viable treatment option for symptomatic degenerative disease involving one tibiofemoral compartment and the lateral patellofemoral joint. This treatment approach may be a useful alternative to TKA or bicompartmental arthroplasty in a carefully selected patient population. Level of evidence Case series—Level IV. Magnussen RA, Gancel E, Servien E, Jacobi M, Demey G, Neyret P, Lustig S. Simultaneous Unicompartmental Knee Arthroplasty and Lateral Patellar Facetectomy for Bicompartmental Degenerative Disease. The Duke Orthop J 2013;3(1):61-66.

scholarly journals Intraoperative rotational kinematics and its influence on postoperative clinical outcomes differ according to age in Unicompartmental knee Arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kohei Kawaguchi ◽  
Hiroshi Inui ◽  
Shuji Taketomi ◽  
Ryota Yamagami ◽  
Kenichi Kono ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Age Differences ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Navigation System ◽  
Knee Flexion ◽  
Functional Score ◽  
Rotational Angle ◽  
Unicompartmental Knee ◽  
Rotational Kinematics

Abstract Background Although Oxford unicompartmental knee arthroplasty (UKA) is used in patients of wide age ranges, there is no clear information regarding the age differences in terms of intraoperative femorotibial rotational kinematics and its influence on clinical outcomes. Therefore, this study was conducted to examine the age differences in terms of intraoperative rotational kinematics and postoperative clinical outcomes and to analyze their relationship with classification according to the age group. Methods We investigated 111 knees of patients who underwent Oxford UKA using a navigation system and divided them into two groups: elderly (aged ≥75 years; 48 knees) and nonelderly (aged < 75 years; 63 knees). Intraoperative tibial internal rotational angles relative to the femur during passive knee flexion were measured using a navigation system, and clinical outcomes were evaluated using knee range of motion, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Knee Society Functional Score at 2 years postoperatively. The relationships between intraoperative tibiofemoral rotational angles and clinical outcomes were also evaluated in the two groups. Results The intraoperative tibial internal rotational angle relative to the femur during knee flexion was significantly larger in the nonelderly group (13.5°) than in the elderly group (9.0°). The intraoperative tibial internal rotational angle showed a positive correlation with the pain subscale of KOOS only in the nonelderly group. Conclusion Intraoperative rotational kinematics and its influence on clinical outcomes were different between elderly and nonelderly patients, and the tibial internal rotational angle could be a more important factor for successful UKA in nonelderly patients.

scholarly journals Intraoperative Rotational Kinematics and Its Influence on Postoperative Clinical Outcomes Differ According to Age in Unicompartmental Knee Arthroplasty 

2021 ◽  
Author(s):  
Kohei Kawaguchi ◽  
Hiroshi Inui ◽  
Shuji Taketomi ◽  
Ryota Yamagami ◽  
Kenichi Kono ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Age Differences ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Navigation System ◽  
Knee Flexion ◽  
Functional Score ◽  
Rotational Angle ◽  
Unicompartmental Knee ◽  
Rotational Kinematics

Abstract Background: Although Oxford unicompartmental knee arthroplasty (UKA) is used in patients of wide age ranges, there is no clear information regarding the age differences in terms of intraoperative femorotibial rotational kinematics and its influence on clinical outcomes. Therefore, this study was conducted to examine the age differences in terms of postoperative clinical outcomes and intraoperative rotational kinematics and to analyze their relationship with classification according to the age group.Methods: We investigated 111 knees of patients who underwent Oxford UKA using a navigation system and divided them into two groups: elderly (aged ≥75 years; 48 knees) and nonelderly (aged <75 years; 63 knees). Intraoperative tibial internal rotational angles relative to the femur during passive knee flexion were measured using a navigation system, and clinical outcomes were evaluated using knee range of motion, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Knee Society Functional Score at 2 years postoperatively. The relationships between intraoperative tibiofemoral rotational angles and clinical outcomes were also evaluated in the two groups. Results: The intraoperative tibial internal rotational angle relative to the femur during knee flexion was significantly larger in the nonelderly group (13.5°) than in the elderly group (9.0°). The intraoperative tibial internal rotational angle showed a positive correlation with the pain subscale of KOOS only in the nonelderly group. Conclusion: Intraoperative rotational kinematics and its influence on clinical outcomes were different between elderly and nonelderly patients, and the tibial internal rotational angle could be a more important factor for successful UKA in nonelderly patients.

scholarly journals Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668429 ◽  
Author(s):  
Yew Lok Woo ◽  
Yong Qiang Jerry Chen ◽  
Mun Chun Lai ◽  
Kheng Jin Darren Tay ◽  
Shi-Lu Chia ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Short Form ◽  
Functional Score ◽  
Fixed Bearing ◽  
Early Failure ◽  
Early Outcome ◽  
Unicompartmental Knee ◽  
Significant Difference

Obesity is a known major contributing risk factor for knee osteoarthritis (OA). It is also believed that obese unicompartmental knee arthroplasty (UKA) patients tend to have poorer outcome and possible early failure. The purpose of this study is to investigate the early outcome of obese UKA patients in a single institution. Patients who underwent fixed bearing medial UKA in between year 2005 and 2010 were included in this study. They were divided into four groups based on Body Mass Index (BMI): 25 kg/m2 (Control); 25–29.9 kg/m2 (Overweight); 30–34.9 kg/m2 (Obese); >35 kg/m2 (Severely Obese). Functional outcome was assessed using Knee Society Score (KSS), Oxford Knee Score (OKS) and Short-form 36 (SF-36). One-way ANOVA with Bonferroni post-hoc test was used to compare the four groups for quantitative variables. There were 673 patients in this study, no significant difference between the four BMI groups for gender and side of operated knee ( p > 0.05). The functional outcome of all four groups at 2 years were comparable (all p > 0.05). At a mean follow up of 5.4 (range 2.5, 8.5) years, 9 revision surgeries (1.3%) were identified. The mean duration from initial surgery to revision surgery was 49 months (Range 6, 90). Patients’ pre-operative BMI did not influence the early outcome of UKA patients. However, patients with higher BMI had relatively lower functional score prior to the surgery and tended to be younger. This did not translate to early failure and the functional improvement was similar among all four groups.

Bone-on-Bone Contact on Radiograph is not a Prerequisite for Successful Outcome in Fixed-Bearing Medial Unicompartmental Knee Arthroplasty—A 10-Year Follow-Up Study

2021 ◽  
Author(s):  
Khai Cheong Wong ◽  
Merrill Lee ◽  
Lincoln Liow ◽  
Ngai-Nung Lo ◽  
Seng-Jin Yeo ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Short Form ◽  
Oxford Knee Score ◽  
Joint Space ◽  
Functional Score ◽  
Knee Score ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty

Abstract Introduction Patients without bone-on-bone osteoarthritis are excluded from mobile-bearing unicompartmental knee arthroplasty due to higher revision rates and poorer outcomes. However, we do not know if the same indication applies to fixed-bearing unicompartmental knee arthroplasty implants. Our study aims to compare functional outcomes and revision rates in patients with and without bone-on-bone arthritis undergoing fixed-bearing medial unicompartmental knee arthroplasty. Materials and Methods We reviewed 153 fixed-bearing medial unicompartmental knee arthroplasties in a single institution. Patients were divided into four groups based on joint space remaining measured on preoperative radiographs. Group 1 included knees with bone-on-bone contact; group 2 included knees with less than 2 mm joint space; group 3 included knees with 2 to 4 mm joint space; group 4 included knees with more than 4 mm joint space. Patients were followed up for 10 years postoperatively and assessed using the Oxford Knee Score, the Functional Score and Knee Score from the Knee Society Clinical Rating Score, and the Short Form 36 Health Survey. Results There was no difference in terms of demographic data and preoperative scores. Postoperative Knee Society Functional Score was found to be lower in group 1 as compared with the other groups. There was no difference between the four groups of patients in terms of Knee Society Knee Score, Oxford Knee Score, and Physical Component Summary and Mental Component Summary Scores from the Short Form 36 Health Survey. There was no difference in terms of survivorship free from all-cause revision at a minimum of 10 years' follow-up. Conclusion Symptomatic patients with varying degrees of arthritis on preoperative radiographs had comparable clinical outcomes. We conclude that symptomatic patients with clinical and radiographic evidence of medial compartment osteoarthritis of any grade can benefit from a fixed-bearing medial unicompartmental knee arthroplasty.

scholarly journals Pain management of unicompartmental (UKA) vs. total knee arthroplasty (TKA) based on a matched pair analysis of 4144 cases

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Florian Zeman ◽  
Winfried Meissner ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Pain Medication ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Pain Scores ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
Pair Analysis

Abstract Unicompartmental knee arthroplasty and total knee arthroplasty are well established treatment options for end-stage osteoarthritis, UKA still remains infrequently used if you take all knee arthroplasties into account. An important factor following knee arthroplasty is pain control in the perioperative experience, as high postoperative pain level is associated with persistent postsurgical pain. There is little literature which describes pain values and the need for pain medication following UKA and/or TKA. So far, no significant difference in pain has been found between UKA and TKA. The aim of the study was to evaluate differences in the postoperative course in unicompartmental knee arthroplasty vs. total knee arthroplasty regarding the need for pain medication and patient-reported outcomes including pain scores and side effects. We hypothesized that unicompartmental knee arthroplasty is superior to total knee arthroplasty in terms of postoperative pain values and the need of pain medication. In this project, we evaluated 2117 patients who had unicompartmental knee arthroplasty and 3798 who had total knee arthroplasty performed, from 2015 to 2018. A total of 4144 patients could be compared after performing the matched pair analysis. A professional team was used for data collection and short patient interviews to achieve high data quality on the first postoperative day. Parameters were compared after performing a 1:1 matched pair analysis, multicenter-wide in 14 orthopedic departments. Pain scores were significantly lower for the UKA group than those of the TKA group (p < 0.001 respectively for activity pain, minimum and maximum pain). In the recovery unit, there was less need for pain medication in patients with UKA (p = 0.004 for non-opioids). The opiate consumption was similarly lower for the UKA group, but not statistically significant (p = 0.15). In the ward, the UKA group needed less opioids (p < 0.001). Patient subjective parameters were significantly better for UKA. After implantation of unicompartmental knee arthroplasty, patients showed lower pain scores, a reduced need for pain medication and better patient subjective parameters in the early postoperative course in this study.

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