5-year cost/benefit analysis of revision of failed unicompartmental knee replacements (UKRs); not “just” a primary total knee replacement (TKR)

Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: A guideline by the working group “Clinical Tissue Regeneration” of the German Society of Orthopaedics and Trauma (DGOU)

“…This means that revision surgery is often necessary in this patient group [111,117] which can also result in higher failure rates [117,118]. Revision of unicompartmental knee replacement also leads to significantly higher subsequent costs in comparison with the implantation of a primary knee prosthesis [119].…”

Revision of a Medial UKA to a Kinematic Aligned TKA: Comparison of Operative Complexity, Postoperative Alignment, and Outcome Scores to a Primary TKA

“…In terms of clinical outcome scores, the mean OKS were 39 and 43 points (p ¼ 0.078), the Visual Analog Pain Scores were 22 and 12 mm (p ¼ 0.069), and the WOMAC scores were 12 and 7 points (p ¼ 0.422), for the revision and control patients, respectively (►Figs. [4][5][6]. The clinical outcome scores reported by revision patients trended 5 to 10% lower than those reported by control patients.…”

“…The mean OKS for the patients with a failed UKA revised to a KA TKA was 39 points, which is higher than the mean 27 to 30 point range reported for revision of a failed UKA to a TKA with the use of MA. [2][3][4][5][6] One reason for the higher OKS with revision to a KA TKA is that four metaanalyses, three randomized trials, and a national multicenter study showed that patients treated with KA TKA reported significantly better pain relief, function, flexion, and a more normal feeling knee than patients treated with MA TKA. [7][8][9][10][11][12][13][14][15] In summary, the use of KA to revise a failed medial UKA to a TKA is a reasonable option as the operative complexity and postoperative alignments are comparable to a primary KA TKA.…”

“…2,3 Studies have reported mean Oxford Knee Scores (OKS) ranging from 27 to 30 points after revision of a failed UKA to a TKA with MA, which is a lower range than those of a primary MA TKA and more comparable to a revision TKA. [2][3][4][5][6] Kinematically aligned (KA) has emerged as a viable alternative to MA TKA as four meta-analyses, three randomized trials, and a national multicenter study showed that patients treated with KA TKA reported significantly better pain relief, function, flexion, and a more normal feeling knee than patients treated with MA TKA, [7][8][9][10][11][12][13][14][15] whereas two randomized trials showed similar clinical outcomes. 16,17 The goal of KA is to co-align the axes and joint lines of the components with the three "kinematic" axes and joint lines of the prearthritic or native knee without placing limits on the preoperative deformity and postoperative correction and without ligament release.…”

Analysing the long-term results of using and those of survival terms for unicompartmental knee arthroplasty

“…The development of osteoarthrosis of the lateral femoral condyle was the cause of total knee arthroplasty in four of them. Some authors reported the lower limb overcorrection to be an often cause of the required performing total interventions after unicompartmental arthroplasty [23,24,25]. In 0.5-3.0 % of cases this has led to polyethylene insert dislocation postoperatively in the short-and mid-term follow-up.…”