scholarly journals A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

2021 ◽  
Vol 6 (10) ◽  
pp. 850-860
Author(s):  
Stein J. Janssen ◽  
Iris van Oost ◽  
Stefan J.M. Breugem ◽  
Rutger C.I. van Geenen
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Comprehensive Evaluation ◽  
Treatment Options ◽  
Accurate Assessment ◽  
Unicompartmental Knee ◽  
Mode Of Failure ◽  
Total Knee ◽  
Diagnostic Modalities ◽  
Oxford Unicompartmental Knee Arthroplasty

Unicompartmental knee arthroplasty (UKA) has several advantages over total knee arthroplasty; however, in many reports, the risk of revision remains higher after UKA. Many reasons for failure of UKA exist. Successful treatment starts with accurate assessment of the symptomatic UKA as a specific mode of failure requires a specific solution. A structured and comprehensive evaluation aids assessment of the symptomatic UKA. This review provides an overview of the causes for a symptomatic medial UKA, its risk factors, diagnostic modalities that can be used, and briefly discusses treatment options. Cite this article: EFORT Open Rev 2021;6:850-860. DOI: 10.1302/2058-5241.6.200105

scholarly journals Bearing Thickness Is Not a Predictive Factor for Damage and Penetration in Oxford Unicompartmental Knee Arthroplasty—A Retrieval Analysis

Materials ◽  
2020 ◽  
Vol 13 (20) ◽  
pp. 4589
Author(s):  
Johannes Adrian Eckert ◽  
Ulrike Mueller ◽  
Tilman Walker ◽  
Martin Schwarze ◽  
Sebastian Jaeger ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Clinical Results ◽  
Material Loss ◽  
Unicompartmental Knee ◽  
Direct Light ◽  
Total Knee ◽  
Oxford Unicompartmental Knee Arthroplasty

The medial Oxford unicompartmental knee arthroplasty (OUKA) shows good survivorship, as well as clinical results. Aseptic loosening, however, remains one of the main reasons for revision and polyethylene debris is known to cause aseptic loosening. The role of bearing thickness in total as well as unicondylar knee arthroplasty has been the subject of controversial discussions, especially the longevity of lower thickness bearings in total knee arthroplasty was questioned. The purpose of this study was to assess the influence of bearing thickness on time to revision, damage pattern, penetration, and volumetric material loss. A cohort of 47 consecutively retrieved medial OUKA bearings was analyzed with conventional direct light microscopy applying the Hood damage analysis, as well as measuring the penetration depth. In this retrieval cohort, a difference on survival time, damage, penetration, as well as volumetric material loss could not be seen. We conclude that low as well as high thickness bearings can safely be used in OUKA without any relevant differences in terms of wear and damage.

scholarly journals Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population-Based Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Shu-Hao Chang ◽  
Chune-Chen Lee ◽  
Chia-Ying Lin ◽  
Yu-Feng Kuo ◽  
Ching-Chuan Jiang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
National Health ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Treatment Options ◽  
Completion Rate ◽  
Research Database ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Total Knee

Background. Current treatment options for both unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are still controversial with no consistent results in which one is superior to others. This is the first study to examine and analyze the following related data available in patients receiving either UKA or TKA from the National Health Research Database (NHIRD) in Taiwan. Methods. The database was searched from NHIRD, pooling one million random patients. Patients’ age, gender, and comorbidities were analyzed in either UKA or TKA between January 2005 and December 2013, or up until death. For the patients that had received bilateral surgeries, further subgrouping was divided into TKA to TKA, UKA to UKA, TKA to UKA, and UKA to TKA to analyze the completion rate curve. Additional analysis of the order codes 64202B, 64053B, and 64198B was defined as failures, and the related failure rate curves were analyzed separately within ten years. Finally, infection-related codes were analyzed. Results. 6,179 patients ( n = 276 UKA; n = 5903 TKA) were selected. Age ( p < 0.0001 ) and gender ( p = 0.037 ) had significant differences, with more young population and males having UKA than TKA. Most comorbidities had no significant difference. For the bilateral surgery analysis, the UKA to UKA group had the fastest completion rate ( p < 0.001 ) and UKA to TKA was the slowest. There were no significant differences in the failure rates of 64202B, 64053B, and 64198B. Conclusion. Most UKA and TKA are appropriate solutions to treat patients with osteoarthritis or osteonecrosis. UKA to UKA is the quickest bilateral completion surgery, and UKA has a higher chance of undergoing revision surgery than TKA.

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.

scholarly journals Complications, Reasons for Reoperation, and 5-Year Prosthesis Survival Compared Between the Cemented and Cementless Oxford Unicompartmental Knee Arthroplasty Fixation Techniques at Thailand’s Largest National Tertiary Referral Center

2021 ◽  
Author(s):  
Jirayu Paugchawee ◽  
Chaturong Pornrattanamaneewong ◽  
Pakpoom Ruangsomboon ◽  
Rapeepat Narkbunnam ◽  
Keerati Chareancholvanich
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cox Proportional Hazards Model ◽  
Implant Survival ◽  
Unicompartmental Knee ◽  
Prosthesis Survival ◽  
Significant Difference ◽  
Oxford Unicompartmental Knee Arthroplasty

Abstract Background: Oxford unicompartmental knee arthroplasty (OUKA) yields favorable outcomes in patients with medial compartmental knee osteoarthritis; however, it remains unknown whether cemented or cementless OUKA fixation delivers better outcomes in Asian population. Accordingly, this study aimed to investigate the complications, reasons for reoperation, and 5-year prosthesis survival compared between cemented and cementless OUKA in Thai patients.Methods: A total of 466 cemented and 36 cementless OUKA that were performed during 2011-2015 with a minimum follow-up of five years were included. With reoperation for any reason as the endpoint, Kaplan-Meier analysis was performed to compare 5-year implant survival between groups. Complications, reasons for reoperation, and 90-day morbidity and mortality were compared between groups. Cox proportional hazards model was used to identify independent predictors of implant survival.Results: There was no significant difference in 5-year implant survival between the cemented and cementless groups (96.4% vs. 94.4%, p=0.375). The mean implant survival time was 113.0±0.8 and 70.8±1.9 months in the cemented and cementless groups, respectively (p=0.383). The most common reason for reoperation was bearing dislocation, and only one patient had 90-day morbidity. There was no significant difference between groups for complications or reasons for reoperation. No independent predictors of implant survival were identified in multivariate analysis.Conclusions: OUKA was shown to be a safe and durable reconstructive procedure in Thai patients with medial compartmental knee osteoarthritis. There was no significant difference in implant survival between the cemented and cementless groups during the 5-year follow-up, and no independent predictors of implant survival were identified. Trial registration: Thai Clinical Trials Registry, TCTR20200427004. Registered 27 April 2020 – Retrospectively registered.

scholarly journals Clinical Results of Oxford Unicompartmental Knee Arthroplasty

2008 ◽  
Vol 57 (4) ◽  
pp. 635-638
Author(s):  
Tetsuya Fukumoto ◽  
Kazutoshi Nomura ◽  
Noburo Hashimoto ◽  
Satoshi Maeda ◽  
Haruhiko Chuma ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Clinical Results ◽  
Unicompartmental Knee ◽  
Oxford Unicompartmental Knee Arthroplasty
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