scholarly journals Unicompartmental knee arthroplasty

2018 ◽  
Vol 3 (6) ◽  
pp. 363-373 ◽  
Author(s):  
E. Carlos Rodríguez-Merchán ◽  
Primitivo Gómez-Cardero
Keyword(s):  
Survival Rate ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Outpatient Surgery ◽  
Mobile Bearing ◽  
X Rays ◽  
Fixed Bearing ◽  
Bone Contact ◽  
Unicompartmental Knee ◽  
Operation Rate

An age younger than 60 years, a body weight of 180 lb (82 kg) or more, performing heavy work, having chondrocalcinosis and having exposed bone in the patellofemoral (PF) joint are not contraindications for unicompartmental knee arthroplasty (UKA). Severe wear of the lateral facet of the PF joint with bone loss and grooving is a contraindication for UKA. Medial UKA should only be performed in cases of severe osteoarthritis (OA) as shown in pre-operative X-rays, with medial bone-on-bone contact and a medial/lateral ratio of < 20%. The post-operative results of UKA are generally good. Medium-term and long-term studies have reported acceptable results at 10 years, with implant survival greater than 95% for UKAs performed for medial OA or osteonecrosis and for lateral UKA, especially when fixed-bearing implants are used. When all implant-related re-operations are considered, the 10-year survival rate is 94%, and the 15-year survival rate is 91%. Aseptic loosening is the principal failure mechanism in the first few years in mobile-bearing implants, whereas OA progression causes most failures in later years in fixed-bearing implants. The overall complication rate and the comprehensive re-operation rate are comparable in both mobile bearings and fixed bearings. The survival likelihood of the all-polyethylene UKA implant is similar to that of metal-backed modular designs for UKA. Notable cost savings of approximately 50% can be achieved with an outpatient UKA surgery protocol. Outpatient surgery for UKA is efficacious and safe, with satisfactory clinical results thus far. Cite this article: EFORT Open Rev 2018;3:363-373. DOI: 10.1302/2058-5241.3.170048

scholarly journals Mobile Versus Fixed Bearing Medial Unicompartmental Knee Arthroplasty: A Series of 375 Patients

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Robert Murphy ◽  
Tyler Fraser ◽  
William Mihalko
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mobile Bearing ◽  
Lateral Compartment ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Component Loosening

Introduction: We sought to compare outcomes, complications and survival between mobile and fixed bearing medial unicompartmental knee arthroplasty (UKA) in a large multi-surgeon group.Methods: Medical records of patients who underwent a medial UKA were queried between March 2003 and August 2012. Variables investigated included final range of motion (ROM), type of complication, and overall survivorship. Results: 375 medial UKAs were analyzed (308 mobile bearing and 67 fixed bearing). Average time to follow-up was 47 months. Final ROM was comparable (mobile: 1-122°, fixed: 1-120°, p = 0.34). Complications occurred in 20/308 (6.6%) mobile bearing UKA and 5/67 (7.5%) fixed bearing UKA (p = 0.77). The most common complications in mobile bearing implants were progression of lateral compartment disease and component loosening. The complications in fixed bearing implants were arthrofibrosis and tibial plateau fracture. Overall survivorship differed, but not significantly (mobile: 94.8%, fixed: 96.9%, p = 0.44). Discussion: In this largest reported cohort series comparing mobile versus fixed bearing UKA, we found no significant difference in final clinical knee range of motion, rates of complications, and survivorship between the two bearing types. 

Risk of revision for medial unicompartmental knee arthroplasty according to fixation and bearing type

2021 ◽  
Vol 103-B (7) ◽  
pp. 1261-1269
Author(s):  
Joost A. Burger ◽  
Hendrik A. Zuiderbaan ◽  
Inger N. Sierevelt ◽  
Liza van Steenbergen ◽  
Peter A. Nolte ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Hospital Volume ◽  
Cox Regression ◽  
Mobile Bearing ◽  
Periprosthetic Fractures ◽  
Fixed Bearing ◽  
Adjusted Risk ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty

Aims Uncemented mobile bearing designs in medial unicompartmental knee arthroplasty (UKA) have seen an increase over the last decade. However, there are a lack of large-scale studies comparing survivorship of these specific designs to commonly used cemented mobile and fixed bearing designs. The aim of this study was to evaluate the survivorship of these designs. Methods A total of 21,610 medial UKAs from 2007 to 2018 were selected from the Dutch Arthroplasty Register. Multivariate Cox regression analyses were used to compare uncemented mobile bearings with cemented mobile and fixed bearings. Adjustments were made for patient and surgical factors, with their interactions being considered. Reasons and type of revision in the first two years after surgery were assessed. Results In hospitals performing less than 100 cases per year, cemented mobile bearings reported comparable adjusted risks of revision as uncemented mobile bearings. However, in hospitals performing more than 100 cases per year, the adjusted risk of revision was higher for cemented mobile bearings compared to uncemented mobile bearings (hazard ratio 1.78 (95% confidence interval 1.34 to 2.35)). The adjusted risk of revision between cemented fixed bearing and uncemented mobile bearing was comparable, independent of annual hospital volume. In addition, 12.3% of uncemented mobile bearing, 20.3% of cemented mobile bearing, and 41.5% of uncemented fixed bearing revisions were for tibial component loosening. The figures for instability were 23.6%, 14.5% and 11.7%, respectively, and for periprosthetic fractures were 10.0%, 2.8%, and 3.5%. Bearing exchange was the type of revision in 40% of uncemented mobile bearing, 24.3% of cemented mobile bearing, and 5.3% cemented fixed bearing revisions. Conclusion The findings of this study demonstrated improved survival with use of uncemented compared to cemented mobile bearings in medial UKA, only in those hospitals performing more than 100 cases per year. Cemented fixed bearings reported comparable survival results as uncemented mobile bearings, regardless of the annual hospital volume. The high rates of instability, periprosthetic fractures, and bearing exchange in uncemented mobile bearings emphasize the need for further research. Cite this article: Bone Joint J 2021;103-B(7):1261–1269.

Fixed-bearing unicompartmental knee arthroplasty tolerates higher variance in tibial implant rotation than mobile-bearing designs

2018 ◽  
Vol 138 (10) ◽  
pp. 1463-1469 ◽  
Author(s):  
Cem Ozcan ◽  
Mehmet Emin Simsek ◽  
Mesut Tahta ◽  
Mustafa Akkaya ◽  
Safa Gursoy ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Unicompartmental Knee
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