scholarly journals Unicompartmental Knee Arthroplasty Over the Past 40 Years: a Global Analysis and Review of the Most Highly Cited Articles

2021 ◽  
Author(s):  
Buchan Jiang ◽  
Cong Wei ◽  
Wenchao Zhang ◽  
Daniel M George ◽  
Ning Tang ◽  
...  
Keyword(s):  
Network Analysis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Global Analysis ◽  
Citation Rate ◽  
Citation Count ◽  
The United States ◽  
Level Of Evidence ◽  
Global Trends ◽  
Unicompartmental Knee

Abstract Background: The aim of this study was to use citation analysis to identify the top 100 papers in unicompartmental knee arthroplasty (UKA) and report the qualities and characteristics of the most influential articles in UKA research.Methods: UKA–related articles published from 1950 to June 2020 were identified using multiple databases. The 100 most cited articles were selected for further analysis of citation count, citation density, current citation rate, authorship, theme, geographic distribution, level of evidence, and network analysis.Results: The top 100 articles' publication dates ranged from 1980 to 2015, with the largest number in the 2000s. Total citations per article ranged from 65 to 473. The USA was the most productive country, but England led the race in terms of citations. The Bone & Joint Journal was the most prolific journal with 25 articles. Price AJ was the most productive first author and corresponding author. The most popular study theme was therapeutic research, followed by prognostic research. The most common level of evidence was level IV. The network analysis connoted that follow-up study had the highest degree of centrality.Conclusions: The study of UKA is steadily evolving. It could be predicted that there will be an increasing number of publications on UKA research in the following years according to the current global trends, the United States and England will likely maintain leadership in this area. Meanwhile, further prospective studies are required to better recognize the prognosis of UKA procedures.

Simultaneous bilateral unicompartmental knee arthroplasty surgery has benefits in low complication rate and cost-effectiveness: a systematic review

2020 ◽  
Vol 5 (4) ◽  
pp. 218-223
Author(s):  
Nicolas Pujol ◽  
Yoshiki Okazaki ◽  
Takayuki Furumatsu
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cost Savings ◽  
Level Of Evidence ◽  
Patient Profile ◽  
One Stage ◽  
Unicompartmental Knee

ImportanceBilateral knee osteoarthritis is frequent and the best choice of treatment remains questionable, especially when the surgeon has to consider simultaneous or staged bilateral unicompartmental knee arthroplasty (UKA).ObjectiveThe purpose of this systematic review was to conduct a systematic review assessing the clinical outcomes associated with simultaneous bilateral and staged bilateral UKA.Evidence reviewA literature search was conducted in June 2019 in Medline, PubMed and Embase. A full-text review of eligible studies was conducted by two investigators.FindingsA total of 10 retrospective studies were identified. These studies described the results of simultaneous bilateral UKA compared either to staged bilateral UKA or unilateral UKA. Results showed that the prevalence of mortality at a minimum of 30 days postoperatively, deep vein thrombosis, the rate of blood transfusion and reintervention were not higher in patients undergoing a one-stage bilateral UKA. The cost-effectiveness is in favour of doing a one-stage procedure due to the shortness of total hospital stay.Conclusions and relevanceOne-stage simultaneous bilateral UKA can be performed with preventing the postoperative complication, and result in cost savings for patients with symptomatic medial bilateral unicompartmental knee osteoarthritis. Further comparative studies are necessary to determine the best patient profile for such a surgery, and the technical considerations during surgery (consecutive surgery or simultaneous surgery with two operative teams).Level of evidenceIV.

scholarly journals Robotic-assisted Unicompartmental knee Arthroplasty optimizes joint line restitution better than conventional surgery

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Roberto Negrín ◽  
Jaime Duboy ◽  
Nicolás O. Reyes ◽  
Maximiliano Barahona ◽  
Magaly Iñiguez ◽  
...  
Keyword(s):  
Femoral Component ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Slope ◽  
Conventional Technique ◽  
Joint Line ◽  
Level Of Evidence ◽  
Robotic Assisted ◽  
Tibial Resection ◽  
Unicompartmental Knee

Abstract Purpose To compare joint line restoration after unicompartmental knee arthroplasty (UKA) between conventional and robotic-assisted surgery. Previous studies have shown that joint line distalization can lead to higher failure rates. The hypothesis was that robotic-assisted UKA is associated with less femoral component distalization and a precise tibial cut, which allows a more anatomical restitution of the knee joint line. Methods Retrospective cohort study of patients undergoing medial or lateral UKA between May 2018 and March 2020. Preoperative and postoperative radiologic assessment of the joint line was performed by two observers, using three different methods, one for tibial slope and one for tibial resection. Robotic assisted UKA and conventional UKA groups were compared. Results Sixty UKA were included, of which 48 (77.42%) were medial. Robotic-assisted UKA were 40 (64.52%) and 22(35.48%) were conventional The distalization of the femoral component was higher in the conventional group despite the method of measurement used In both Weber methods, the difference was statistically different: Conventional 2.3 (0.9 to 5.6) v/s Robotic 1.5 (− 1.1 to 4.1) (p =0.0025*). A higher proportion of patients achieved a femoral component position ≤ two millimeters from the joint line using robotic-assisted UKA compared to the conventional technique . No statistical difference between robotic-assisted and conventional UKA was found in tibial resection and slope. Conclusion Robotic-assisted UKA shows a better rate of joint line restoration due to less femoral component distalization than conventional UKA. No difference was found in the amount of tibial resection between groups in this study. Level of evidence III

scholarly journals Radiological outcomes following manual and robotic-assisted unicompartmental knee arthroplasty

2021 ◽  
Vol 2 (3) ◽  
pp. 191-197
Author(s):  
Gregory S. Kazarian ◽  
Robert L. Barrack ◽  
Toby N. Barrack ◽  
Charles M. Lawrie ◽  
Ryan M. Nunley
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Robotic System ◽  
Target Range ◽  
Implant Survival ◽  
Level Of Evidence ◽  
Robotic Assisted ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Survival Level

Aims The purpose of this study was to compare the radiological outcomes of manual versus robotic-assisted medial unicompartmental knee arthroplasty (UKA). Methods Postoperative radiological outcomes from 86 consecutive robotic-assisted UKAs (RAUKA group) from a single academic centre were retrospectively reviewed and compared to 253 manual UKAs (MUKA group) drawn from a prior study at our institution. Femoral coronal and sagittal angles (FCA, FSA), tibial coronal and sagittal angles (TCA, TSA), and implant overhang were radiologically measured to identify outliers. Results When assessing the accuracy of RAUKAs, 91.6% of all alignment measurements and 99.2% of all overhang measurements were within the target range. All alignment and overhang targets were simultaneously met in 68.6% of RAUKAs. When comparing radiological outcomes between the RAUKA and MUKA groups, statistically significant differences were identified for combined outliers in FCA (2.3% vs 12.6%; p = 0.006), FSA (17.4% vs 50.2%; p < 0.001), TCA (5.8% vs 41.5%; p < 0.001), and TSA (8.1% vs 18.6%; p = 0.023), as well as anterior (0.0% vs 4.7%; p = 0.042), posterior (1.2% vs 13.4%; p = 0.001), and medial (1.2% vs 14.2%; p < 0.001) overhang outliers. Conclusion Robotic system navigation decreases alignment and overhang outliers compared to manual UKA. Given the association between component placement errors and revision in UKA, this strong significant improvement in accuracy may improve implant survival. Level of Evidence: III Cite this article: Bone Jt Open 2021;2-3:191–197.

scholarly journals UNICOMPARTIMENTAL KNEE ARTHROPLASTY - 15 YEARS FOLLOW UP

2020 ◽  
Vol 28 (5) ◽  
pp. 233-235
Author(s):  
GILBERTO LUIS CAMANHO
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Case Series ◽  
Level Of Evidence ◽  
Unicompartmental Knee ◽  
Long Term Follow Up ◽  
Lost To Follow Up ◽  
Knee Arthroplasty Surgery ◽  
Arthroplasty Surgery

ABSTRACT Objective: To evaluate clinically and radiologically the long-term follow-up of patients with anteromedial osteoarthritis who underwent unicompartmental knee arthroplasty surgery. Methods: This study included 36 patients who underwent unicompartmental knee arthroplasty surgery for medial compartmental osteoarthritis with a minimum of 15-year post-operative follow-up. All surgeries were performed by a single surgeon (G.L.C) using the Miller-Galante unicompartmental knee implant. Patients were analyzed regarding their clinical functional and implant radiographic conditions. Results: From the 46 patients who could have completed 15 years of follow-up, three required revision surgery with conversion to total knee arthroplasty (6.5%), 36 completed the 15-year follow-up period, and the others were lost to follow-up for reasons not related to unicompartmental arthroplasty. Conclusion: In these 36 patients, the result was satisfactory after follow-up, with complaints and sign of progression of osteoarthritis in some cases. Level of Evidence IV, Case series.

scholarly journals Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Brandon L. Morris ◽  
Jack M. Ayres ◽  
Daniel Reinhardt ◽  
Armin Tarakemeh ◽  
Scott Mullen ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Complication Rates ◽  
Opioid Use ◽  
Level Of Evidence ◽  
Medicare Population ◽  
Unicompartmental Knee ◽  
Lower Complication ◽  
Icd 10 ◽  
Outcome Differences

Abstract Purpose Despite increased utilization of unicompartmental knee arthroplasty (UKA) for unicompartmental knee osteoarthritis, outcomes in Medicare patients are not well-reported. The purpose of this study is to analyze practice patterns and outcome differences between UKA and TKA in the Medicare population. It is hypothesized that UKA utilization will have increased over the course of the study period and that UKA will be associated with reduced opioid use and lower complication rates compared to TKA. Methods Using PearlDiver, the Humana Claims dataset and the Medicare Standard Analytic File (SAF) were analyzed. Patients who underwent UKA and TKA were identified by CPT codes. Postoperative complications were identified by ICD-9/ICD-10 codes. Opioid use was analyzed by the number of days patients were prescribed opioids postoperatively. Survivorship was defined as conversion to TKA. Results In the Humana dataset, 7,808 UKA and 150,680 TKA patients were identified. 8-year survivorship was 87.7% (95% CI [0.861,0.894]). Postoperative opioid use was significantly higher after TKA (186.1 days) compared to UKA (144.7 days) (p < 0.01, Δ = 41.1, 95% CI = [30.41, 52.39]). In the SAF dataset, 20,592 UKA patients and 110,562 TKA patients were identified. Survivorship was highest in patients > 80 years old and lowest in patients < 70 years old. In both datasets, postoperative complication rates were higher in TKA patients compared to UKA patients in nearly all categories. Conclusions UKA represents an increasingly utilized treatment for osteoarthritis in the Medicare population and may be comparatively advantageous to TKA due to reduced opioid use and complication rates after surgery. Level of evidence Level III

Unicompartmental Knee Arthroplasty in Octogenarians versus Younger Patients: A Comparison of 30-Day Outcomes

2020 ◽  
Author(s):  
Michael D. Kavanagh ◽  
Matthew V. Abola ◽  
Joseph E. Tanenbaum ◽  
Derrick M. Knapik ◽  
Steven J. Fitzgerald ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
The United States ◽  
Improvement Program ◽  
Younger Patients ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AbstractAs the United States' octogenarian population (persons 80–89 years of age) continues to grow, understanding the risk profile of surgical procedures in elderly patients becomes increasingly important. The purpose of this study was to compare 30-day outcomes following unicompartmental knee arthroplasty (UKA) in octogenarians with those in younger patients. The American College of Surgeons National Surgical Quality Improvement Program database was queried. All patients, aged 60 to 89 years, who underwent UKA from 2005 to 2016 were included. Patients were stratified by age: 60 to 69 (Group 1), 70 to 79 (Group 2), and 80 to 89 years (Group 3). Multivariate regression models were estimated for the outcomes of hospital length of stay (LOS), nonhome discharge, morbidity, reoperation, and readmission within 30 days following UKA. A total of 5,352 patients met inclusion criteria. Group 1 status was associated with a 0.41-day shorter average adjusted LOS (99.5% confidence interval [CI]: 0.67–0.16 days shorter, p < 0.001) relative to Group 3. Group 2 status was not associated with a significantly shorter LOS compared with Group 3. Both Group 1 (odds ratio [OR] = 0.15, 99.5% CI: 0.10–0.23) and Group 2 (OR = 0.33, 99.5% CI: 0.22–0.49) demonstrated significantly lower adjusted odds of nonhome discharge following UKA compared with Group 3. There was no significant difference in adjusted odds of 30-day morbidity, readmission, or reoperation when comparing Group 3 patients with Group 1 or Group 2. While differences in LOS and nonhome discharge were seen, octogenarian status was not associated with increased adjusted odds of 30-day morbidity, readmission, or reoperation. Factors other than age may better predict postoperative complications following UKA.

scholarly journals Low percentage of surgeons meet the minimum recommended unicompartmental knee arthroplasty usage thresholds: Analysis of 3037 Surgeons from Three National Joint Registries

2021 ◽  
Author(s):  
Antonio Klasan ◽  
David A. Parker ◽  
Peter L. Lewis ◽  
Simon W. Young
Keyword(s):  
New Zealand ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Pooled Analysis ◽  
Registry Study ◽  
Level Of Evidence ◽  
Unicompartmental Knee ◽  
Time Period ◽  
The Uk

Abstract Purpose The reported usage of UKA is around 10% in the UK, Australian and New Zealand joint registries. However, some authors recommend that a higher UKA usage of 20%, or a minimum 12 UKA cases per year, would reduce revision rates. The purpose of this study was to analyze the percentage of surgeons performing the recommended thresholds in these 3 registries. Methods Data from the UK, Australian and New Zealand registry databases was utilized from the time period since their respective introduction until 2017. All primary TKA and UKA performed for the diagnosis of osteoarthritis by surgeons with more than 100 recorded knee arthroplasties in their respective registry were included. The results between the registries were compared and a pooled analysis was performed. The number of surgeons meeting the recommended caseload of > 20% UKA yearly or 12 UKA cases yearly was calculated. Results We identified 3037 knee surgeons performing 1,556,440 knee arthroplasties, of which 131,575 were UKA (8.45%). Over 50% of knee surgeons in each registry had a proportion of less than 5% UKA of their knee replacement procedures. After pooling of data, median surgeon UKA usage was 2.0% (IQR 0–9.1%). The percentage of surgeons meeting the proposed caseload criteria was highest in New Zealand, 16.3%, followed by the UK at 12.4% and Australia 11.3% (p = 0.28). Conclusion More than 50% of knee surgeons in UK, Australian and New Zealand joint registries perform less than 5% of UKA yearly. The majority of experienced knee surgeons are not meeting the recommended minimum thresholds, which might indicate that the recommended thresholds are not feasible for the vast majority of knee surgeons. The reasons behind this require further research. Level of Evidence Level III retrospective registry study.

scholarly journals TRENDS IN UNICOMPARTMENTAL KNEE ARTHROPLASTY

2020 ◽  
Vol 28 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Ahmet Nadir Aydemir ◽  
Mehmet Yucens
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Case Reports ◽  
Research Articles ◽  
Patient Specific ◽  
Level Of Evidence ◽  
Specific Level ◽  
Unicompartmental Knee ◽  
Patient Specific Instrumentation ◽  
Thomson Reuters

ABSTRACT Objective: To evaluate trends in publications on unicompartmental knee arthroplasty (UKA) from the past to the present. Methods: As a web-based analysis, all UKA research articles, editorial letters, case reports, reviews and meeting abstracts published on the Thomson Reuters’ Web of Knowledge were evaluated. The period from the first publication in 1980 to January 2019 was divided into four decades and publications were evaluated. Research articles were grouped into headings according to the subjects. Results: A total of 1,658 publications were evaluated in this study. The most frequent term used in the publications title was “outcome,” with 260 items, followed by “biomechanics and kinematics,” with 99 items. Most reports have been published in the last decade, and the most common type of publication was postoperative follow-up and results. Conclusion: In parallel with technological advancements, publications related to UKA-especially patient-specific instrumentation, navigation, and robotic surgery-will increase in number and become more specific. Level of Evidence V, Expert Opinion.

scholarly journals The most influential papers in unicompartmental knee arthroplasty

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Lukas A. Holzer ◽  
Gerold Holzer
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Geographic Origin ◽  
Absolute Number ◽  
Osteoarthritis Of The Knee ◽  
Journal Title ◽  
Level Of Evidence ◽  
Unicompartmental Knee ◽  
Publication Number ◽  
Number Of Citations

Abstract Purpose Unicompartmental knee arthroplasty (UKA) is a treatment option for anteromedial osteoarthritis of the knee. The number of UKA has been increasing constantly worldwide in recent decades. The aim of this study was to determine the most frequently cited scientific articles addressing this subject and to establish a ranking of the 50 most influential papers. Methods The 50 most cited articles related to UKA were searched in Web of Science® (Clarivate Analytics, Penn., USA) by the use of defined search terms. All types of scientific papers with reference to this topic were ranked according to the absolute number of citations and analyzed for the following characteristics: journal title, year of publication, number of citations, citation density, geographic origin, article type, and level of evidence. Results The 50 most cited articles had up to 453 citations. Most papers were published in the Journal of Bone and Joint Surgery (British volume). More than half of the articles were published in the 2000s and 2010s (n = 30). Ten countries contributed to the top 50 list, with most contributions from the UK (n = 17). Most articles could be attributed to the category of Clinical Science (n = 33), and most reported level IV studies. Conclusion Most of the frequently cited articles in UKA are clinical studies that have a low level of evidence. Few basic scientific studies could be identified, which suggests that most product development is done by commercial companies.

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