Unicompartmental Knee Replacement Did Not Differ from Total Knee Replacement with Regard to Clinical Outcomes at 15 Years

2009 ◽  
Vol 91 (8) ◽  
pp. 2012 ◽  
Author(s):  
J Newman ◽  
RV Pydisetty ◽  
C Ackroyd ◽  
Javad Parvizi
Keyword(s):  
Total Knee Replacement ◽  
Clinical Outcomes ◽  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Unicompartmental Knee ◽  
Total Knee

Unicompartmental knee replacement

2011 ◽  
Author(s):  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Total Knee Replacement ◽  
Hospital Stay ◽  
Knee Replacement ◽  
Treatment Option ◽  
Unicompartmental Knee Replacement ◽  
Range Of Movement ◽  
Single Compartment ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
End Stage

♦ 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

scholarly journals Unicompartmental knee replacement - An Underrated Alternative of Total Knee Replacement: A Matched Comparative Study Analysing Their Benefits and Risks in Local Population

2018 ◽  
Vol 25 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Tarn Karson ◽  
Lee Qun-Jid ◽  
Wong Yiu-Chung
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Local Population ◽  
Operation Time ◽  
Womac Score ◽  
Unicompartmental Knee Replacement ◽  
Control Group ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Total Knee

Introduction The demand of knee arthroplasty is increasing worldwide with aging population. Even though unicompartmental knee replacement is associated with fewer complications namely stroke, myocardial infarction, thrombo-embolism, blood transfusion and mortality, it merely comprises 3–8% of knee arthroplasties. The aim of the study is to establish the role of unicompartmental knee replacement by evaluating the benefits and risks of unicompartmental knee replacement versus total knee replacement in Hong Kong population. Methods All unicompartmental knee replacement performed in our institute from 2011 to 2014 were reviewed. Comparative analyses were performed on pre-operative, operative and post-operative parameters. Primary total knee replacement performed in the same period was chosen as control group with 1:1 matching for age, sex, BMI and pre-operative range of motion. Results There were 46 unicompartmental knee replacement. It comprises 3.3% of all knee arthroplasties in our institute. The mean follow-up time was 12.8 months (4–38 months). There was no significant difference in all pre-operative parameters except WOMAC score. All operative parameters favored unicompartmental knee replacement significantly (operation time 76 vs 91 minutes; wound size 7.5 vs 12.4 cm; haemoglobin drop 0.75 vs 2.46g/dl, p < 0.05). Early post-operative parameters also favored unicompartmental knee replacement (Deep vein thrombosis rate 4.3 vs 23.9%; length of stay 5.4 vs 7.0 days, p < 0.05). There was no infection or mortality in both groups. Conclusion Because of less operative risk and faster rehabilitation, this study suggested that unicompartmental knee replacement is more cost effective and might be a better choice for patients with unicompartmental arthritis in local population.

Revision of failed unicompartmental knee replacement to total knee replacement

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 356-359 ◽  
Author(s):  
Daud T.S. Chou ◽  
Girish N. Swamy ◽  
James R. Lewis ◽  
Nitin P. Badhe
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Unicompartmental Knee ◽  
Total Knee

Revision of medial Oxford unicompartmental knee replacement to a total knee replacement: Similar to a primary?

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 339-343 ◽  
Author(s):  
Henry Wynn Jones ◽  
Warwick Chan ◽  
Timothy Harrison ◽  
Toby O. Smith ◽  
Patrick Masonda ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Unicompartmental Knee ◽  
Total Knee

scholarly journals Unicompartmental compared with total knee replacement for patients with multimorbidities: a cohort study using propensity score stratification and inverse probability weighting

2021 ◽  
Vol 25 (66) ◽  
pp. 1-126
Author(s):  
Albert Prats-Uribe ◽  
Spyros Kolovos ◽  
Klara Berencsi ◽  
Andrew Carr ◽  
Andrew Judge ◽  
...  
Keyword(s):  
Propensity Score ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Inverse Probability Weighting ◽  
Unicompartmental Knee Replacement ◽  
Probability Weighting ◽  
Inverse Probability ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
Propensity Score Stratification

Background Although routine NHS data potentially include all patients, confounding limits their use for causal inference. Methods to minimise confounding in observational studies of implantable devices are required to enable the evaluation of patients with severe systemic morbidity who are excluded from many randomised controlled trials. Objectives Stage 1 – replicate the Total or Partial Knee Arthroplasty Trial (TOPKAT), a surgical randomised controlled trial comparing unicompartmental knee replacement with total knee replacement using propensity score and instrumental variable methods. Stage 2 – compare the risk benefits and cost-effectiveness of unicompartmental knee replacement with total knee replacement surgery in patients with severe systemic morbidity who would have been ineligible for TOPKAT using the validated methods from stage 1. Design This was a cohort study. Setting Data were obtained from the National Joint Registry database and linked to hospital inpatient (Hospital Episode Statistics) and patient-reported outcome data. Participants Stage 1 – people undergoing unicompartmental knee replacement surgery or total knee replacement surgery who met the TOPKAT eligibility criteria. Stage 2 – participants with an American Society of Anesthesiologists grade of ≥ 3. Intervention The patients were exposed to either unicompartmental knee replacement surgery or total knee replacement surgery. Main outcome measures The primary outcome measure was the postoperative Oxford Knee Score. The secondary outcome measures were 90-day postoperative complications (venous thromboembolism, myocardial infarction and prosthetic joint infection) and 5-year revision risk and mortality. The main outcome measures for the health economic analysis were health-related quality of life (EuroQol-5 Dimensions) and NHS hospital costs. Results In stage 1, propensity score stratification and inverse probability weighting replicated the results of TOPKAT. Propensity score adjustment, propensity score matching and instrumental variables did not. Stage 2 included 2256 unicompartmental knee replacement patients and 57,682 total knee replacement patients who had severe comorbidities, of whom 145 and 23,344 had linked Oxford Knee Scores, respectively. A statistically significant but clinically irrelevant difference favouring unicompartmental knee replacement was observed, with a mean postoperative Oxford Knee Score difference of < 2 points using propensity score stratification; no significant difference was observed using inverse probability weighting. Unicompartmental knee replacement more than halved the risk of venous thromboembolism [relative risk 0.33 (95% confidence interval 0.15 to 0.74) using propensity score stratification; relative risk 0.39 (95% confidence interval 0.16 to 0.96) using inverse probability weighting]. Unicompartmental knee replacement was not associated with myocardial infarction or prosthetic joint infection using either method. In the long term, unicompartmental knee replacement had double the revision risk of total knee replacement [hazard ratio 2.70 (95% confidence interval 2.15 to 3.38) using propensity score stratification; hazard ratio 2.60 (95% confidence interval 1.94 to 3.47) using inverse probability weighting], but half of the mortality [hazard ratio 0.52 (95% confidence interval 0.36 to 0.74) using propensity score stratification; insignificant effect using inverse probability weighting]. Unicompartmental knee replacement had lower costs and higher quality-adjusted life-year gains than total knee replacement for stage 2 participants. Limitations Although some propensity score methods successfully replicated TOPKAT, unresolved confounding may have affected stage 2. Missing Oxford Knee Scores may have led to information bias. Conclusions Propensity score stratification and inverse probability weighting successfully replicated TOPKAT, implying that some (but not all) propensity score methods can be used to evaluate surgical innovations and implantable medical devices using routine NHS data. Unicompartmental knee replacement was safer and more cost-effective than total knee replacement for patients with severe comorbidity and should be considered the first option for suitable patients. Future work Further research is required to understand the performance of propensity score methods for evaluating surgical innovations and implantable devices. Trial registration This trial is registered as EUPAS17435. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 66. See the NIHR Journals Library website for further project information.

scholarly journals Migration of the femoral component and clinical outcomes after total knee replacement: a narrative review

2020 ◽  
Author(s):  
R. Zinno ◽  
S. Di Paolo ◽  
G. Ambrosino ◽  
D. Alesi ◽  
S. Zaffagnini ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Clinical Outcomes ◽  
Femoral Component ◽  
Knee Replacement ◽  
Narrative Review ◽  
Alternative Solution ◽  
Total Knee ◽  
Long Term Performance ◽  
Term Performance ◽  
Cobalt Chrome

AbstractLoosening is considered as a main cause of implant failure in total knee replacement (TKR). Among the predictive signs of loosening, migration is the most investigated quantitative parameter. Several studies focused on the migration of the tibial component in TKR, while no reviews have been focused on the migration of the femoral component and its influence on patients’ clinical outcomes. The aim of this narrative review was (1) to provide information about of the influence of migration in femoral component of TKR prostheses, (2) to assess how migration may affect patient clinical outcomes and (3) to present alternative solution to the standard cobalt-chrome prostheses. A database search was performed on PubMed Central® according to the PRISMA guidelines for studies about Cobalt-Chrome femoral component migration in people that underwent primary TKR published until May 2020. Overall, 18 articles matched the selection criteria and were included in the study. Few studies investigated the femoral component through the migration, and no clear migration causes emerged. The Roentgen Stereophotogrammetric Analysis has been mostly used to assess the migration for prognostic predictions. An annual migration of 0.10 mm seems compatible with good long-term performance and good clinical and functional outcomes. An alternative solution to cobalt-chrome prostheses is represented by femoral component in PEEK material, although no clinical evaluations have been carried out on humans yet. Further studies are needed to investigate the migration of the femoral component in relation to clinical outcomes and material used.

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