scholarly journals Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

2021 ◽  
Vol 11 (8) ◽  
pp. 753
Author(s):  
Cyrus Anthony Pumilia ◽  
Lennart Schroeder ◽  
Nana O. Sarpong ◽  
Gregory Martin
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Phone Call ◽  
Survivorship Analysis ◽  
Computed Tomography Images ◽  
Unicompartmental Knee ◽  
Implant Survivorship ◽  
Patient Reported

Customized unicompartmental knee arthroplasty (C-UKA) utilizes implants manufactured on an individual patient basis, derived from pre-operative computed tomography images in an effort to more closely approximate the natural anatomy of the knee. The outcomes from 349 medial and lateral fixed-bearing C-UKA were reviewed. Implant survivorship analysis was conducted via retrospective chart review, and follow-up analysis was conducted via a single postoperative phone call or email. The rate of follow-up was 69% (242 knees). The average age at surgery was 71.1 years and the average body mass index was 28.8 kg/m2. Seven revision arthroplasties (2.1%) had knowingly been performed at an average of 1.9 years postoperatively (range: 0.1–3.9 years), resulting in an implant survivorship of 97.9% at an average follow-up of 4.2 years (range: 0.1–8.7) and 97.9% at an average of 4.8 years (range: 2.0–8.7) when knees with less than two years of follow-up were excluded. The reasons for revision were implant loosening (one knee), infection (two knees), progression of osteoarthritis (two knees), and unknown reasons (two knees). The average KOOS, JR. interval score was 84 (SD: 14.4). Of those able to be contacted for follow-up analysis, 67% were “very satisfied,” 26% were “satisfied,” 4% were “neutral,” 2% were “dissatisfied,” and 1% were “very dissatisfied.” When asked if the knee felt “natural,” 60% responded with “always,” 35% responded with “sometimes,” and 5% responded with “never.” After analyzing a large cohort of C-UKA, we found favorable rates of survivorship, satisfaction, and patient-reported functional outcomes.

Mid-Term Evaluation of the Unicompartmental Knee Arthroplasty in Patients with BMI of 40 or Greater

2019 ◽  
Author(s):  
Akshay Seth ◽  
Johanna Dobransky ◽  
Waleed Albishi ◽  
Geoffrey F. Dervin
Keyword(s):  
Survival Rate ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Primary Objective ◽  
Term Survival ◽  
Unicompartmental Knee ◽  
Patient Reported

AbstractLimited evidence is available on mid-term follow-up for patients with body mass index (BMI) ≥ 40 receiving a unicompartmental knee arthroplasty (UKA). The primary objective of this study was to investigate survival of the UKA in patients with BMI ≥ 40. Secondary objectives were to assess functional and patient reported outcome measures (PROMs). Survival analysis with endpoint revision of any component for any reason was conducted using Kaplan–Meier technique on 121 knees (103 patients) that underwent UKA with Oxford Phase 3 implant (Oxford Knee, Biomet, Swindon, United Kingdom) between September 2001 and March 2014 by seven surgeons. Survivorship differences were compared using Log Rank (Mantel-Cox) tests, and Cox Proportional Hazard Model was used to assess predictors of failure. Preoperative PROMs were compared at 2 and 5 years postoperatively using paired t-tests. Mean age of patients was 58 years (43–75), mean BMI 43 kg/m2 (40–51), and mean follow-up 7 years (2 months to 15 years). Survival rate for the whole cohort was 92% at 2 years and 86% at 5 years. Females had a significantly higher revision rate than males (p = 0.043). A total of 19 knees required revision (16 to TKA, 2 polyethylene liner exchanges, and 1 femoral component and liner revision). With respect to PROMs, there was a significant improvement at 2 and 5 years (p < 0.001) on 4 of 5 knee injury and osteoarthritis outcome score subscales. The mid-term survival rate for the Oxford UKA in patients with morbid obesity is similar to that of other nondesigner patient series with BMI ≥ 30, which provides further evidence for the safety of the implant in this patient population with significant improvements on PROMs at short and mid-term follow-up.

Evaluation of Safety and Medium-Term Functional Outcomes of a Medial Fixed-Bearing Unicompartmental Knee Arthroplasty with Ultra-Highly Cross-Linked Polyethylene

2020 ◽  
Author(s):  
Megan Richards ◽  
Johanna S. Dobransky ◽  
Alanna A. Jane ◽  
Geoffrey F. Dervin
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Polyethylene Wear ◽  
Case Series ◽  
P Value ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Patient Reported

AbstractThe primary objective of this study was to evaluate the in vivo safety of a unicompartmental knee arthroplasty design with sequentially annealed cross-linked polyethylene by evaluating reoperation rate, in particular those related to excessive polyethylene wear or breakage. The secondary objective was to examine functional outcomes via standardized questionnaires. This was a 5-year institutional review board-approved prospective single-surgeon case series of the first 152 consecutive patients with symptomatic medial unicompartmental osteoarthritis implanted with a partial knee replacement between May 2010 and December 2014. Study participants were asked to complete the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC) questionnaires at preoperation and 2 to 5 years postoperation. Major complications and all reoperations were recorded and we produced Kaplan–Meier survivorship curves with the end point of revision to TKA. Pre- and postoperative differences for KOOS and WOMAC were evaluated by paired t-tests. The median length of follow-up was 7.2 (0–9.72) years. Seven patients required revision surgery to TKA (4.9% of patients): four with progression of arthritis in other compartments, two for infection, and one for loosening of the femoral component and subsequent progression of pain. There were no failures of polyethylene. Survival of cohort was 99.3 and 97.9% at 2 and 5 years, respectively. Patients significantly improved (p-value < 0.001) between preoperative assessment and at 2 years, with no decline at 5 years postoperation. These preliminary midterm results with this fixed-bearing design and cross-linked polyethylene were encouraging with no catastrophic failures of polyethylene. Patient reported outcomes were significantly improved and revision rates were acceptable and lower than registry reported results.

scholarly journals Cementless unicompartmental knee arthroplasty results in higher pain levels compared to the cemented technique: a prospective register study

2021 ◽  
Author(s):  
Tone Gifstad ◽  
Jørgen Jebens Nordskar ◽  
Tarjei Egeberg ◽  
Tina Strømdal Wik ◽  
Siri Bjørgen Winther
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Short Form ◽  
Fixation Method ◽  
Unicompartmental Knee ◽  
Prosthetic Joint Infections ◽  
Patient Reported ◽  
Duration Of Surgery ◽  
Pain At Rest

Abstract Purpose In recent years, the preferred fixation method for unicompartmental knee arthroplasty (UKA) has changed from cemented to cementless. The aim of this study was to compare patient-reported outcome measures (PROMs) from the cemented versus cementless techniques two- and twelve-months post-operation. Methods From 2015 to 2019, 187 cemented and 261 cementless UKAs were included based on an institutional registry. The Oxford Unicompartmental Knee System™ (Zimmer Biomet, Bridgend, United Kingdom) was used for all patients. Three experienced surgeons performed all procedures. Data were collected pre- and peroperatively, and at two- and twelve-months postoperatively. PROMs included pain (evaluated on a numeric rating scale [NRS] during activity and at rest), and knee function (evaluated with the disease-specific short form of the Knee injury and Osteoarthritis Outcome Score [KOOS-PS]). Patients also rated postoperative joint function (better, unchanged, uncertain or worse) and were asked, “based on your experience to date, would you go through the surgery again?”. Duration of surgery was noted and revisions during the first post-operative year were evaluated. Results The cemented group reported significantly lower activity-related pain at both two- and twelve-month follow-up. This was also the case for pain at rest at twelve-month follow-up, and KOOS-PS at two-month follow-up. Duration of surgery (adjusted for surgeon differences) was eight minutes less on average with the cementless technique. Eleven prosthetic joint infections (PJIs) were found following the cementless fixation technique compared to three using the cemented implant. Conclusion UKA cases with cemented implants had lower pain scores during activity two and twelve months after surgery compared with those who had cementless implants. Differences in favor of the cemented group were also found for pain at rest one year after surgery and for KOOS-PS two months after. Surgery was significantly shorter in duration in the cementless group, but a relatively high number of PJIs were found in that same group. Level of evidence Level II.

scholarly journals Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee: A meta-analysis

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877092 ◽  
Author(s):  
Julio J Jauregui ◽  
Christopher L Blum ◽  
Neil Sardesai ◽  
Craig Bennett ◽  
R Frank Henn ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Unicompartmental Knee ◽  
Spontaneous Osteonecrosis ◽  
Boolean Search ◽  
Total Knee

Background: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK’s predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK. Methods: A systematic literature search was performed to evaluate all studies examining patients who underwent UKA for SONK. Screening of the articles was performed using multiple Boolean search strings, methodological index for non-randomized studies criteria, and other selected exclusion criteria. Results: Seven studies were included, with a total of 276 knees (273 patients). The mean age was 68 years (64–74 years), with a mean body mass index of 26 kg/m2 (25–29 kg/m2). The final range of motion was 125° (124–126°). Standardized mean difference (SMD) of clinical improvement pre- and post-outcome was 3.39 ( p < 0.001). The improvement in the visual analog score was 57.03 points, with an SMD of 4.57 ( p < 0.001). Revision rates were determined to be 5.51% (95% confidence interval of 1.96–10.69%). Conclusion: Our meta-analysis demonstrated that in properly selected patients, UKA could be an excellent alternative to TKA for patients with SONK. These data show that UKA has few complications, significant improvements on functional outcomes, and good survivorship at a mean follow-up of 6 years.

scholarly journals Robotic technology: current concepts, operative techniques and emerging uses in unicompartmental knee arthroplasty

2020 ◽  
Vol 5 (5) ◽  
pp. 312-318
Author(s):  
Fahima A. Begum ◽  
Babar Kayani ◽  
Samuel D. J. Morgan ◽  
Syed S. Ahmed ◽  
Sandeep Singh ◽  
...  
Keyword(s):  
Learning Curve ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Inpatient Rehabilitation ◽  
Case Volume ◽  
Implant Positioning ◽  
Unicompartmental Knee ◽  
Implant Survivorship

Unicompartmental knee arthroplasty (UKA) is associated with improved functional outcomes but reduced implant survivorship compared to total knee arthroplasty (TKA). Surgeon-controlled errors in component positioning are the most common reason for implant failure in UKA, and low UKA case-volume is associated with poor implant survivorship and earlier time to revision surgery. Robotic UKA is associated with improved accuracy of achieving the planned femoral and tibial component positioning compared to conventional manual UKA. Robotic UKA has a learning curve of six operative cases for achieving operative times and surgical team comfort levels comparable to conventional manual UKA, but there is no learning curve effect for accuracy of implant positioning or limb alignment. Robotic UKA is associated with reduced postoperative pain, decreased opiate analgesia requirements, faster inpatient rehabilitation, and earlier time to hospital discharge compared to conventional manual UKA. Limitations of robotic UKA include high installation costs, additional radiation exposure with image-based systems, and paucity of studies showing any long-term differences in functional outcomes or implant survivorship compared to conventional manual UKA. Further clinical studies are required to establish how statistical differences in accuracy of implant positioning between conventional manual UKA and robotic UKA translate to long-term differences in functional outcomes, implant survivorship, complications, and cost-effectiveness. Cite this article: EFORT Open Rev 2020;5:312-318. DOI: 10.1302/2058-5241.5.190089

Midterm results of a new personalized knee implant for total knee arthroplasty: implant survivorship and patient-reported outcome after five years’ follow-up

2021 ◽  
Author(s):  
Cristina Dauder Gallego ◽  
Irene Blanca Moreno Fenoll ◽  
José Luis Patiño Contreras ◽  
Francisco Javier Moreno Coronas ◽  
María del Carmen Torrejón de la Cal ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcome ◽  
Midterm Results ◽  
Implant Survivorship ◽  
Patient Reported ◽  
Total Knee

scholarly journals Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre

2021 ◽  
Author(s):  
D. M. Moore ◽  
G. A. Sheridan ◽  
A. Welch-Phillips ◽  
J. M. O’Byrne ◽  
P. Kenny
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Womac Score ◽  
Long Term Results ◽  
Secondary Outcome ◽  
Osteoarthritis Of The Knee ◽  
Phase 3 ◽  
Unicompartmental Knee ◽  
Aseptic Revision

Abstract Purpose Unicompartmental knee arthroplasty (UKA) provides patients with an alternative treatment to TKA in isolated medial compartment osteoarthritis providing better functional outcomes and faster recovery in the short term. Our aim was to quantify revision rates, predictors of revision, mortality rate and functionality of the Oxford Phase 3 UKA in a non-designer institution. Methods This was a retrospective review of prospectively collected regional registry data. All Oxford Phase 3 UKAs performed for medial tibio-femoral osteoarthritis of the knee joint were included from a single academic institution between the period of January 1st 2006 and December 30th 2009. Kaplan-Meier survivorship curves adjusting for loss to follow-up and deceased patients were generated. Primary outcome variables included all-cause and aseptic revision. Secondary outcome variables included functional outcome scores. Patients were reviewed at 6 months, 2 years, 5 years, 10 years and 15 years. Results A total of 64 cemented Oxford phase 3 UKAs were performed between January 2006 and November 2009. Fifteen-year follow-up data were available for 51 patients, of these 12 required revision. Survival rates, adjusting for patients that were either lost to follow-up or deceased, were 87.5% at 5 years, 81.4% at 10 years and 76.4% at 15 years. The overall aseptic revision rate at the time of review was 18.75% (n = 12). The only significant predictor of postoperative WOMAC score at 15 years was the preoperative WOMAC score (p = 0.03). Conclusion The Oxford Phase 3 UKA for medial tibio-femoral arthritis has promising outcomes at 15-year follow-up with a survival rate of 76.4% in a non-designer centre. Level of Evidence III.

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