Annual revision rates of partial versus total knee arthroplasty: A comparative meta-analysis

Chawla, Harshvardhan; List, Jelle P. van der; Christ, Alexander B.; Sobrero, Maximiliano; Zuiderbaan, Hendrik A.; Pearle, Andrew D.

doi:10.1016/j.knee.2016.11.006

Cited by 100 publications

(68 citation statements)

References 149 publications

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“…Postoperatively, 13% of patients retained their anatomic nasal deformities [10]. The revision rate associated with rhinoplasty is influenced by this lack of anatomic correction [10] and is, notably, much higher than the revision rate for articular cartilage repair procedures (5.2%) and total knee arthroplasties (0.49%) [12,13]. Despite the evolution of surgical rhinoplasty techniques [14], the frequency of rhinoplasty operations, in combination with their high revision rates, highlights the importance and need for their continued refinement.…”

Section: *Statement Of Significancementioning

confidence: 99%

Toward tissue-engineering of nasal cartilages

et al. 2019

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Section: *Statement Of Significancementioning

confidence: 99%

Toward tissue-engineering of nasal cartilages

et al. 2019

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“…Insbesondere beim jüngeren Patienten ist die Frage nach der erwarteten Haltbarkeit des Implantats für die Wahl zwischen unikondylär und bikondylär relevant. Der unikondyläre Oberflächenersatz ist dem bikondylären Oberflächenersatz hier klar unterlegen [13,14,25]. Während die 10-Jahres-Überlebensrate beim bikondylären Ersatz in den Registern mit 94-97 % angegeben wird, liegt diese beim unikondylären Ersatz nur bei 85-88 % [13,14].…”

Section: üBerlebenunclassified

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

2017

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In end-stage medial osteoarthritis, the surgeon can decide whether to use unicompartmental or total knee arthroplasty for operative treatment of the patient. Despite the available literature there is a lack of evidence to suggest if one procedure can be rated as being superior to the other. With increasing demand for knee arthroplasty, treatment with the highest expectation of success will be of particular interest. The purpose of this manuscript was to analyse and compare the available literature on unicompartmental vs. total knee arthroplasty for the treatment of medial osteoarthritis. In this review of literature, the two procedures were compared regarding their clinical outcome, implant survival, and complication rates. Regarding the clinical outcome the unicompartmental knee arthroplasty was shown to be superior over total knee arthroplasty. However, studies were mostly retrospective and groups were also different preoperatively. Patients treated with unicompartmental knee arthroplasty had better preoperative range of motion and function scores. Unicompartmental and total knee arthroplasty showed comparably increased functional scores. Taking the implant survival as parameter, institutional registries, multicenter studies and arthroplasty registries found total knee arthroplasties to have a significantly better long-term survival in comparison to unicompartmental knee arthroplasty. However, data might be biased by the lower threshold to revise unicompartmental knee arthroplasty due to expected simple revision and more subjective indications for revision. Looking at the complication rate, one has to differentiate between general and implant-specific complications. While the unicompartmental knee arthroplasty was shown to be advantageous in terms of general complications and mortality, it was also shown to be inferior in terms of implant-specific complications. The available literature does not show one procedure to be superior to the other. The trend to a better clinical outcome and a lower mortality rate is advantageous for unicompartmental knee arthroplasty, while the better long-term survival and a lower risk of implant-specific complications may make total knee arthroplasty preferable.

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“…Both procedures significantly reduce pain and improve function for the majority of patients, but comparative evidence suggests that partial replacement is associated with better functional outcome [14,15]. Yet, long-term studies and registry data show that the revision rate is higher following partial than total knee replacement [12,13,16,17].…”

Section: Introductionmentioning

confidence: 99%

Partial or total knee replacement? Identifying patients’ information needs on knee replacement surgery: a qualitative study to inform a decision aid

et al. 2019

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Purpose For patients with end-stage knee osteoarthritis, joint replacement is a widely used and successful operation to help improve quality-of-life when non-operative measures have failed. For a significant proportion of patients there is a choice between a partial or total knee replacement. Decision aids can help people weigh up the need for and benefits of treatment against possible risks and side-effects. This study explored patients' experiences of deciding to undergo knee replacement surgery to identify information priorities, to inform a knee replacement decision aid. Methods Four focus groups were held with 31 patients who were candidates for both partial and total knee replacement surgery. Two focus groups included patients with no prior knee replacement surgery (pre-surgery); two with patients with one knee already replaced and who were candidates for a second surgery on their other knee (post-surgery). Data were analysed using Framework Analysis. Results Participants described a process of arriving at 'readiness for surgery' a turning point where the need for treatment outweighed their concerns. Referral and personal factors influenced their decision-making and expectations of surgery in the hope to return to a former self. Those with previous knee surgery offered insights into whether their expectations were met. 'Information for decisions' details the practicality and the optimal timing for the delivery of a knee replacement decision aid. In particular, participants would have valued hearing about the experiences of other patients and seeing detailed pictures of both surgical options. Information priorities were identified to include in a decision aid for knee replacement surgery. Conclusions Patients' experiences of surgical decision-making have much in common with the Necessity-Concerns Framework. Whilst originally developed to understand drug treatment decisions and adherence, it provides a useful lens to understand decision-making about surgery. The use of a decision aid could enhance decision-making on knee replacement surgery. Ultimately, patients' understanding of the risks and benefits of both surgical options could be improved and in turn, help informed decision-making. The knee replacement decision aid is perceived as a useful tool to be associated with other detailed information resources as recommended.

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Annual revision rates of partial versus total knee arthroplasty: A comparative meta-analysis

Cited by 100 publications

References 149 publications

Toward tissue-engineering of nasal cartilages

Toward tissue-engineering of nasal cartilages

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

Partial or total knee replacement? Identifying patients’ information needs on knee replacement surgery: a qualitative study to inform a decision aid

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