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.

scholarly journals The effects of patello-femoral arthrosis to the outcome of unicompartmental arthroplasty

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Tolga Tüzüner ◽  
Ayşe Esin Uygur ◽  
Esra Çirçi ◽  
Murat Eren ◽  
Ziya Demirci
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Knee Society Score ◽  
Oxford Knee Score ◽  
Functional Results ◽  
Unicompartmental Knee ◽  
Number Of Patients ◽  
Significant Difference ◽  
Grade 3

Purpose: Unicompartmental knee arthroplasty is developed for the treatment of unicompartment arthrosis. Participation of multi compartments to the disease and patello-femoral arthrosis classically form a contraindication for this surgery. Different opinions were reported in literature on this subject. In this study, the effects of the presence of patello-femoral arthrosis on post-operative clinical and functional outcomes and revision process were investigated. Method: Pre-operative magnetic resonance (MR) images of 52 patients undergone medial unicompartmental knee arthroplasty between the years of 2011-2016 who completed minimum 6 months of follow-up period were evaluated. According to the presence of patello-femoral arthrosis, patients were classified into groups as non-arthrosis, grade 1-2 and grade 3-4. Statistical comparison were performed on knee society score (KSS), functional knee society score (fKSS), Oxford knee score (OKS), visual analog scale (VAS) score and post-operative joint range of motion (ROM) results. Results: 24 of 52 patients had no patello-femoral arthrosis. 13 patients were diagnosed with grade 1-2 and 15 patients were diagnosed with grade 3-4 patello-femoral arthrosis. No statistically significant difference was observed in patello-femoral arthrosis groups in average post-operative KSS, fKSS, OKS, VAS values. No revision proceeding was demonstrated in regression analysis. Conclusion: The results obtained from this study demonstrated that patello-femoral arthrosis has no effect on clinical and functional results. Yet, it is also considered that there is no factor to affect the implant survival rate. Having that said, when the number of patients and relatively short follow-up periods are considered, it is our opinion that new studies are required in this matter. [Figure: see text]

scholarly journals Hybrid Oxford unicompartmental knee arthroplasty has lower residual cement extrusion than cemented arthroplasty in treating end-stage unicompartmental knee osteoarthritis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Guangzhong Yang ◽  
Xufeng Jiao ◽  
Qianli Li ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Short Term ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
End Stage ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Hybrid Group

Abstract Background Hybrid Oxford unicompartmental knee arthroplasty (OUKA) consists of cementless femoral prostheses and cemented tibial prostheses. Although a hybrid OUKA has been used in clinical practice, the clinical outcome has not been reported. The purpose of this study was to compare the short-term clinical outcomes and rate of residual bone cement extrusion between hybrid and cemented prostheses and analyse the possible reasons for differences between outcomes. Methods A total of 128 knees (118 patients) with end-stage osteoarthritis were included in this study, of which underwent consecutive operations using unicondylar Oxford phase 3 implants from July 2017 and September 2019 in our centre. Follow-up was performed at 6 weeks, 3 and 6 months, 1 year and every year after operation, and complications and changes in the Oxford knee score (OKS) were recorded. The OKS of the two groups was analysed by the generalized estimating equation approach. Prosthesis-based standard fluoroscopy was performed in a timely manner after each operation, and the rate of residual cement extrusion of the two groups was estimated using T-tests and a multivariate regression analysis. Results Excluding the cases that lost follow-up, a total of 120 knees (65 in hybrid group and 55 in cemented group) were included in the analysis. There was no statistically significant difference in patient characteristics between the two groups (p > 0.05). The average follow-up time was 23.4 months (and ranged from 12 to 38 months). As of the last follow-up, there were no complications, such as dislocation, fracture, prosthesis loosening and subsidence, but one patient in the cemented group experienced symptoms caused by residual loose cement. Postoperative OKS in both groups improved significantly (p < 0.001). There was no significant difference in the OKS at any point during the follow-up or in the improvement of the OKS between the two groups (p > 0.05). Residual cement was mainly extruded behind the tibial prosthesis. The rate of hybrid periprosthetic residual cement extrusion was significantly lower in the hybrid group than in the cemented group, and the difference was statistically significant (OR = 3.38; p = 0.014). Conclusions Hybrid OUKA is as effective as cemented OUKA in the short term after operation and can significantly reduce the residual cement extrusion rate around the tibial prosthesis.

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

2018 ◽  
Vol 32 (02) ◽  
pp. 186-191 ◽  
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.

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 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 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.

scholarly journals High usage of medial unicompartmental knee arthroplasty negatively influences total knee arthroplasty revision rate

2021 ◽  
Author(s):  
Antonio Klasan ◽  
Mei Lin Tay ◽  
Chris Frampton ◽  
Simon William Young
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Revision Rate ◽  
Oxford Knee Score ◽  
High Volume ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Total Knee

Abstract Purpose Surgeons with higher medial unicompartmental knee arthroplasty (UKA) usage have lower UKA revision rates. However, an increase in UKA usage may cause a decrease of total knee arthroplasty (TKA) usage. The purpose of this study was to investigate the influence of UKA usage on revision rates and patient-reported outcomes (PROMs) of UKA, TKA, and combined UKA + TKA results. Methods Using the New Zealand Registry Database, surgeons were divided into six groups based on their medial UKA usage: < 1%, 1–5%, 5–10%, 10–20%, 20–30% and > 30%. A comparison of UKA, TKA and UKA + TKA revision rates and PROMs using the Oxford Knee Score (OKS) was performed. Results A total of 91,895 knee arthroplasties were identified, of which 8,271 were UKA (9.0%). Surgeons with higher UKA usage had lower UKA revision rates, but higher TKA revision rates. The lowest TKA and combined UKA + TKA revision rates were observed for surgeons performing 1–5% UKA, compared to the highest TKA and UKA + TKA revision rates which were seen for surgeons using > 30% UKA (p < 0.001 TKA; p < 0.001 UKA + TKA). No clinically important differences in UKA + TKA OKS scores were seen between UKA usage groups at 6 months, 5 years, or 10 years. Conclusion Surgeons with higher medial UKA usage have lower UKA revision rates; however, this comes at the cost of a higher combined UKA + TKA revision rate that is proportionate to the UKA usage. There was no difference in TKA + UKA OKS scores between UKA usage groups. A small increase in TKA revision rate was observed for high-volume UKA users (> 30%), when compared to other UKA usage clusters. A significant decrease in UKA revision rate observed in high-volume UKA surgeons offsets the slight increase in TKA revision rate, suggesting that UKA should be performed by specialist UKA surgeons. Level of evidence III, Retrospective therapeutic study.

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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