scholarly journals Unicompartmental knee arthroplasty for spontaneous osteonecrosis

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769032 ◽  
Author(s):  
Tong Ma ◽  
Yihui Tu ◽  
Huaming Xue ◽  
Tao Wen ◽  
Jiong Mei
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Lateral Compartment ◽  
Phase Iii ◽  
Complication Rates ◽  
Effective Treatment Option ◽  
Unicompartmental Knee ◽  
Spontaneous Osteonecrosis ◽  
The Mean

Background: Unicompartmental knee arthroplasty (UKA) is an effective treatment option for medial compartment osteoarthritis (OA) of the knee. Whether spontaneous osteonecrosis of the knee (SPONK) can be successfully treated with UKA remains controversial. This study evaluated the clinical and radiological results of patients with SPONK who were treated by UKA using Oxford phase III prostheses. Methods: We compared a prospective series of 23 UKA cases operated for SPONK with 235 UKA cases operated for OA. All patients underwent Magnetic Resonance Imaging (MRI) to confirm the diagnosis and exclude any major lesion in the lateral compartment. The stage, condylar ratio, and volume of the necrotic lesion were evaluated. The pre and postoperative Oxford knee scores (OKSs) were compared. Results: The mean follow-up was 60 months. No statistical differences in complication rates between the groups were found. The mean OKS improved from 39.48 ± 5.69 to 18.83 ± 3.82 ( p < 0.05). There were no significant differences in the pre and postoperative OKS between the different groups. Conclusion: SPONK can be successfully treated with UKA, with a favorable short- to mid-term follow-up.

scholarly journals Short-term effectiveness of medial unicompartmental knee arthroplasty in young patients aged less than or equal to 60 years

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902094511
Author(s):  
Fangxing Wang ◽  
Huaming Xue ◽  
Tong Ma ◽  
Tao Wen ◽  
Tao Yang ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Young Patients ◽  
Visual Analogue Score ◽  
Midterm Results ◽  
Effective Treatment Option ◽  
Unicompartmental Knee ◽  
Before And After

Purpose: The treatment for young patients with advanced knee arthritis by Oxford unicompartmental knee arthroplasty (Oxford-UKA) is still controversial. A relative few studies were published about Asian patients. We evaluated midterm results of Oxford-UKA in young patients aged less than or equal to 60 years. Methods: Between December 2009 and December 2018, 95 patients (109 knees) (mean age 57.48 years; range: 33–60 years) were included. The mean follow-up period was 3.0 years (range: 1.0–9.5 years). The functional outcomes and pain score of the knee before and after surgery were examined. Results: To the last follow-up, no patient died, six patients (nine knees) were lost and one patient underwent total knee revision in case of unexplained postoperative pain. The patients demonstrated significant improvement in range of knee motion (103.65 vs. 115.96, p < 0.05), Oxford Knee Score (40.0 vs. 14.4, p < 0.05), Hospital for Special Surgery Score (56.0 vs. 85.7, p < 0.05), and Visual Analogue Score (VAS) (5.23 vs. 1.08, p < 0.05) before and after surgery. Conclusion: Our midterm results showed that the Oxford-UKA was a reliable and effective treatment option for young patients aged less than or equal to 60 years with anterior medial osteoarthritis. The knee pain can be effectively relieved and excellent functional activities of the knee joint can be obtained after surgery.

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

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.

scholarly journals Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee: A meta-analysis

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877092 ◽  
Author(s):  
Julio J Jauregui ◽  
Christopher L Blum ◽  
Neil Sardesai ◽  
Craig Bennett ◽  
R Frank Henn ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Unicompartmental Knee ◽  
Spontaneous Osteonecrosis ◽  
Boolean Search ◽  
Total Knee

Background: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK’s predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK. Methods: A systematic literature search was performed to evaluate all studies examining patients who underwent UKA for SONK. Screening of the articles was performed using multiple Boolean search strings, methodological index for non-randomized studies criteria, and other selected exclusion criteria. Results: Seven studies were included, with a total of 276 knees (273 patients). The mean age was 68 years (64–74 years), with a mean body mass index of 26 kg/m2 (25–29 kg/m2). The final range of motion was 125° (124–126°). Standardized mean difference (SMD) of clinical improvement pre- and post-outcome was 3.39 ( p < 0.001). The improvement in the visual analog score was 57.03 points, with an SMD of 4.57 ( p < 0.001). Revision rates were determined to be 5.51% (95% confidence interval of 1.96–10.69%). Conclusion: Our meta-analysis demonstrated that in properly selected patients, UKA could be an excellent alternative to TKA for patients with SONK. These data show that UKA has few complications, significant improvements on functional outcomes, and good survivorship at a mean follow-up of 6 years.

scholarly journals Clinical Efficacy of Unicompartmental Knee Arthroplasty in the Treatment of Spontaneous Osteonecrosis of the Knee

2020 ◽  
Author(s):  
Hao Li ◽  
Ting ting Liu ◽  
Min Zhang
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Stage Iv ◽  
Knee Joints ◽  
Short Term ◽  
Vas Score ◽  
Unicompartmental Knee ◽  
Spontaneous Osteonecrosis ◽  
Before And After

Abstract BackgroundThis retrospective study aimed to evaluate the short-term effectiveness of unicompartmental knee arthroplasty (UKA) in the treatment of spontaneous osteonecrosis of the knee (SONK).MethodsThe patients who were diagnosed as SONK and received UKA in our hospital from January 2012 to January 2018 were retrospectively analyzed. The patients were diagnosed and staged by X-ray and MRI techniques before surgery. The range of motion (ROM), femorotibial angle (FTA), and visual analog scale (VAS) score of patients' knee joints were assessed before and after surgery. Clinical outcomes were evaluated by the hospital for special surgery (HSS) knee score.ResultsA total of 18 patients with spontaneous osteonecrosis (4 males and 14 females; mean age: 62.5 years) met the inclusion criteria participated in this study. According to the Mont grades, 12 cases (66.7%) were in stage III, and 6 cases (33.3%) were in stage IV. The average follow-up was 19.6 months. At the last follow-up, it was found that the hospital for HSS score was increased from 61.22 ± 2.90 to 91.0 ± 2.89 (P < 0.05); VAS score was decreased from 6.44 ± 1.04 to 1.94 ± 0.99 (P < 0.05); FTA was improved from 178.42 ± 0.84 to 176.17 ± 0.87 (P < 0.05); ROM (120.17 ± 5.88) was not significantly different from that before surgery (119.61 ± 5.56, P = 0.601).ConclusionThe encouraging results of this study indicate that UKA has an excellent short-term clinical effect in the treatment of SONK.

scholarly journals Unicompartmental Knee Arthroplasties are Performed on the Patients with Radiologically Too Mild Osteoarthritis

2017 ◽  
Vol 106 (4) ◽  
pp. 338-341 ◽  
Author(s):  
J. Knifsund ◽  
J. Hatakka ◽  
H. Keemu ◽  
K. Mäkelä ◽  
M. Koivisto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Joint Space Width ◽  
Joint Space ◽  
Phase Iii ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
The Mean ◽  
Space Width

Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates. Aims: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty. Methods: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years. Results and Conclusion: The knees with a preoperative Kellgren–Lawrence grade of 0–2 osteoarthritis had a higher risk of reoperation than those with a Kellgren–Lawrence grade of 3–4 (odds ratio = 1.89; 95% confidence interval, 1.03–3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.

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

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.

Patient-acceptable symptom state for reporting outcomes following unicompartmental knee arthroplasty

2021 ◽  
Vol 103-B (8) ◽  
pp. 1367-1372
Author(s):  
Kevin D. Plancher ◽  
Jasmine E. Brite ◽  
Karen K. Briggs ◽  
Stephanie C. Petterson
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Intact Group ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Patient Acceptable Symptom State ◽  
Acl Deficient ◽  
Deficient Group

Aims The patient-acceptable symptom state (PASS) is a level of wellbeing, which is measured by the patient. The aim of this study was to determine if the proportion of patients who achieved an acceptable level of function (PASS) after medial unicompartmental knee arthroplasty (UKA) was different based on the status of the anterior cruciate ligament (ACL) at the time of surgery. Methods A total of 114 patients who underwent UKA for isolated medial osteoarthritis (OA) of the knee were included in the study. Their mean age was 65 years (SD 10). No patient underwent a bilateral procedure. Those who had undergone ACL reconstruction during the previous five years were excluded. The Knee injury Osteoarthritis Outcome Score Activities of Daily Living (KOOS ADL) function score was used as the primary outcome measure with a PASS of 87.5, as described for total knee arthroplasty (TKA). Patients completed all other KOOS subscales, Lysholm score, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Veterans Rand 12-item health survey score. Failure was defined as conversion to TKA. Results Survivorship at ten years was 97% in both the ACL-deficient and ACL-intact groups. The mean survival was 16.1 years (95% confidence interval (CI) 15.3 to 16.8) for the ACL-deficient group and 15.6 years (95% CI 14.8 to 16.361) for the ACL-intact group (p = 0.878). At a mean of nine years (SD 3.5) in the ACL-deficient group, 32 patients (87%) reached the PASS for the KOOS ADL. In the ACL-intact group, at a mean of 8.6 years (SD 3) follow-up, 63 patients (85%) reached PASS for the KOOS ADL. There was no significant difference in the percentage of patients who reached PASS for all KOOS subscales and Lysholm between the two groups. Conclusion PASS was achieved in 85% of all UKAs for KOOS ADL, similar to reports for TKA. Fixed-bearing, medial, non-robotically-assisted UKA resulted in 97% survival at ten years in both the ACL-deficient and ACL-intact groups. There was no significant difference in all outcomes between the two groups. Understanding PASS will allow better communication between surgeons and patients to improve the surgical management of patients with single compartment OA of the knee. This study provides mid- to long-term data supporting the use of PASS to document outcomes following UKA. PASS was met in more than 85% of patients with no differences between ACL-deficient and ACL-intact knees at a mean follow-up of nine years. Cite this article: Bone Joint J 2021;103-B(8):1367–1372.

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