Technical Considerations and Survivorship of Unicompartmental Knee Replacements to Total Knee Replacement Revisions in a Single Center

OrthoMedia ◽  
2022 ◽  
2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Johannes Holz ◽  
Stefan Schneider ◽  
Ansgar Ilg ◽  
Rene Kaiser

Aims and Objectives: The purpose was to evaluate the clinical outcomes of patients with knee osteoarthritis treated with bicompartmental arthroplasty (BKA) in comparison to unicompartmental (UKA), patellofemoral (PFA) and total knee arthroplasty (TKA) in a single center. Materials and Methods: This is a prospective study analyzing a consecutive series of 396 patients from two surgeons in a single center. In 191 men and 205 women either partial or total knee replacement were performed. Their mean age at surgery was 63±6,85 years and mean BMI 29,55±5,00 kg/m2. In 238 patients UKA, in 125 TKA, in 21 PFA and in 11 patients BKA was performed. Implants were cemented and made of cobalt chrome in partial knee and zirconium oxide in total knee replacement. Demographics and patient reported outcomes (VAS, KOOS, Oxford Knee Score (OKS)) were collected preoperatively and 3,6 and 12 months postoperatively. A total of 202 patients have thus far completed the 12 months follow-up time point. Results: All mean KOOS and OKS scores improved significantly 1 year after surgery (p<0.05). Mean preoperative aggregated KOOS improved from 49,0±14,1 to 74,3±17,8 in UKA, from 44,1±12,9 to 67,5±9,4 in PFA, from 46,1±15,1 to 71,0±14,8 in TKA and from 45,7±13,8 to 72,6±9,7 in BKA (p<0.05). Mean preoperative aggregated OKS improved from 25,1±7,6) to 38,5±9,7 in UKA, from 23,0±7,6 to 36,8±3,8 in PFA, from 23,4±8,2 to 37,3±8,1 in TKA and from 22,9±9,6 to 37,0±1,5 in BKA (p<0.05). The mean pain level (VAS)decreased from pre-treatment to 12 months after surgery in UKA from 5,5 to 1,6, in PFA from 6,1 to 2,5, in TKA from 6,0 to 1,9 and in BKA from 6,6 to 2,6. One patient (0.4%) underwent revision (at 3 month for inlay dislocation). Conclusion: This study shows excellent early clinical results of patients treated with unicompartmental, bicompartmental and total knee arthroplasty. Adherence to strict indications lead to a significant improvement of patient reported outcomes and a low revision rate one year postoperatively. The reported results for BKA are comparable to those of patients treated with unicompartmental arthroplasty. We conclude that bicompartmental arthroplasty is a safe and reliable surgery for patients with bicompartmental osteoarthritis.


2019 ◽  
Vol 26 (2) ◽  
pp. 99-104
Author(s):  
Michelle Kar Lam Li ◽  
Lawrence Chun Man Lau ◽  
Yuk Wah Hung ◽  
Ka Bon Kwok ◽  
Alexander Pak Hin Chan ◽  
...  

Rotating platform total knee replacement implants have been marketed to allow more precise approximation of normal knee kinematics and enhance patella tracking. At liberty of rotation, the distinct mobile polyethylene insert design does have its pitfalls in spite of purported merits. We report a case of lateral knee pain following rotating platform total knee replacement, attributable to iliotibial band impingement by the rotating polyethylene insert. Prompt treatment via arthroscopic release circumvented a traumatic and costly revision procedure.


The Knee ◽  
1995 ◽  
Vol 2 (2) ◽  
pp. 121-125 ◽  
Author(s):  
JG Martin ◽  
DA Wallace ◽  
DA Woods ◽  
AJ Carr ◽  
DW Murray

Author(s):  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray

♦ Ideal treatment option for end-stage osteoarthritis affecting a single compartment of the knee♦ Unicompartmental knee replacement has many advantages over total knee replacement• Restores near normal kinematics• Usually gives a better range of movement• Patients require a shorter hospital stay• Fewer serious complications


1998 ◽  
Vol 26 (4) ◽  
pp. 530-535 ◽  
Author(s):  
Neil Bradbury ◽  
David Borton ◽  
Geoff Spoo ◽  
Mervyn J. Cross

Return to regular sports activity was evaluated in a retrospective review of 160 patients who had undergone total knee replacement surgery by a single surgeon (208 knee replacements). Mean age of the patients was 68 years (range, 27 to 87) at surgery and 73 years (range, 33 to 91) at review at a mean follow-up of 5 years (range, 3 to 7). Seventy-nine patients regularly participated in sports, at least once per week, before surgery, and 51 patients regularly participated in sports after surgery. Only eight patients took up sports after surgery who were not regularly involved in sports in the year before surgery. Patients were more likely to return to low-impact activities such as bowls (29 of 32, or 91%) than to high-impact activities such as tennis (6 of 30, or 20% returned). Forty-three of 56 patients (77%) who had participated in regular exercise in the year before surgery returned to sports. Eighty patients did not participate in sports before surgery and 54 of these had coexisting disease that prevented sports. None of these patients returned to sports.


Author(s):  
Kelly Vince ◽  
Jacob Munro

♦ Understanding the reason for failure of the original knee replacement is crucial prior to revision♦ The surgery should be a revision and not a repeat of the failed arthroplasty♦ There are eight reasons for failure of original knee replacements which should each be approached individually♦ Unexplained pain relating to a knee replacement requires further investigation before revision surgery can occur♦ Successful revision surgery is performed in three steps – preparation of a tibial surface, the knee in flexion and the knee in extension


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