Bearing Dislocation and Progression of Osteoarthritis After Mobile-bearing Unicompartmental Knee Arthroplasty Vary Between Asian and Western Patients: A Meta-analysis

Ro, Kyung Han; Heo, Jae-Won; Lee, Dae-Hee

doi:10.1007/s11999.0000000000000205

Cited by 31 publications

(43 citation statements)

References 52 publications

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“…Alignment errors may have adverse effects on the wear rate of the mobile bearing, changes in knee kinematics, and implant loosening or failure [28]. Malpositioning may also increase the risk of bearing dislocation in mobile UKA, which highlights the importance of alignment accuracy [9,10]. On radiographic evaluation, tibial prosthetic component alignment was usually good, and alignment as it was visually aligned and easily performed.…”

Section: Discussionmentioning

confidence: 99%

“…However, this procedure is recognized as a technical challenge, especially when the device is implanted with a minimally invasive incision, which potentially results in component malposition and incorrect alignment [8]. Malposition increases the risk of bearing dislocation in mobile UKA, a serious complication that usually requires revision surgery [9][10][11]. Incorrect alignment in the coronal plane can also influence the outcome of UKA [12,13].…”

Section: Introductionmentioning

confidence: 99%

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A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

et al. 2020

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Background: The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine the radiographic accuracy and early clinical outcomes of the extramedullary method. Methods: We retrospectively evaluated 50 consecutive patients who underwent UKA using the extramedullary technique. An equal number of patients who underwent UKA with the conventional technique were matched as the control group. Clinical outcomes were evaluated in terms of the operating time, blood loss, range of motion, and Hospital for Special Surgery score. Radiographic accuracy was evaluated by the implant position and alignment in the coronal and sagittal planes. Results: The mean follow-up period was 39.76 ± 5.77 months. There were no differences in the postoperative Hospital for Special Surgery score, range of motion, or hip-knee-ankle angle between the two groups. The operating time in the extramedullary group was shorter than that in the conventional group (54.78 ± 7.95 vs. 59.14 ± 10.91 min, respectively; p = 0.025). The drop in hemoglobin after 3 days was only 12.34 ± 4.98 g/L in the extramedullary group which was less than that in the conventional group (p = 0.001). No significant differences were found in the postoperative coronal and sagittal angles between the two groups. Acceptable radiographic accuracy of the implant alignment and position was achieved in 92% of patients in the extramedullary group and 96% of patients in the conventional group. Conclusions: The radiographic and clinical results of the extramedullary technique were comparable with those of the conventional technique with the advantage of no intramedullary interruption, less blood loss, a shorter operating time, and more rapid recovery. As the technique depends on the accurate tibial cut and overall alignment, we do not recommend it to surgeons without high volume experiences. Trial registration: Retrospectively registered

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

et al. 2020

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“…Symptoms are generally managed with conservative therapies. Patients and their physicians often turn to surgical treatments to address progressive pain and disability, including arthroscopy and total knee arthroplasty (TKA) (Bonanzinga et al, 2018;Ro, Heo, & Lee, 2018). However, in 6 months after TKA, 16-39% of patients still sustain knee pain (Liang, Cai, Li, & Ma, 2017).…”

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confidence: 99%

Curcumin reduces inflammation in knee osteoarthritis rats through blocking TLR4 /MyD88/NF‐κB signal pathway

Zhang

Zeng

2019

Drug Development Research

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Preclinical Research & Development Curcumin has been shown to possess a series of beneficial effects, such as antiinflammatory, antioxidant, analgesic, and promoting healing. However, the effect and relative mechanism of curcumin on knee osteoarthritis (OA) have not been elucidated. The aim of this study is to explore the protective effect of curcumin on monosodium iodoacetate (MIA)‐induced OA. Forty‐eight rats were randomized into four experimental groups: control group, OA group, OA + PBS group, and OA + curcumin group, respectively. A single intraarticular injection of MIA was applied to establish the rat model of knee OA. Hematoxylin–eosin staining was used to evaluate histological changes of knee joint. The paw withdrawal threshold was collected and the expression of synovial fluid cytokine levels was measured by ELISA. The protein expression of TRL‐4, MyD88, p‐IκBα, NF‐κB, TNF‐α, IL‐1β, and IL6 was measured by western blot. Treating with curcumin can significantly reduce joint diameter and Mankin's score, and increase the paw withdrawal threshold. The expression of synovial fluid inflammatory biomarkers, IL‐6, IL‐1β, and TNF‐α in the OA + curcumin group were lower than that in OA and OA + PBS group. The protein expression of the TLR4 receptor was increased in the OA, OA + PBS, and OA + curcumin group compared to the control group. However, curcumin treatment can significantly decrease the expression of MyD88, p‐IκBα, NF‐κB, TNF‐α, IL‐1β, and IL6 in OA + curcumin group. These findings may indicate that curcumin could block TLR4/NF‐κB signal pathway, and reduce inflammation level to prevent knee wound in OA rats. Curcumin may be a feasible kind of medicament in the treatment of knee OA.

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“…First, it included only one randomized prospective study; most of the others were case-control studies. Second, UKA has very different complication spectrums between Western and Asian patients [21]. In our review, however, the NJR report had substantial weight on the assessment of the clinical outcomes, while the Asian reports contributed only minor effects; this may have led to a selective bias.…”

Section: Discussionmentioning

confidence: 79%

“…Therefore, the revision rate is described as revisions per 100 component years with the 95% CI [9,21].…”

Section: Discussionmentioning

confidence: 99%

Does new instrument for Oxford unicompartmental knee arthroplasty improve short-term clinical outcome and component alignment? A meta-analysis

Sun

Zou

et al. 2020

J Orthop Surg Res

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Background The Microplasty (MP) instrumentation designed for the Phase III Oxford mobile-bearing unicompartmental knee arthroplasty (UKA) system is considered a better option to achieve more accurate component positioning and alignment. In the present study, we focused on short-term clinical and radiological outcomes to determine whether the MP instrumentation can reduce the short-term revision rate and occurrence of outliers of metallic components. Methods The literature in PubMed, Embase, the Cochrane Library, and Web of Science was searched up to May 2020. Studies were scrutinized by two independent authors, and the revision rate, complication spectrum, and radiological assessment with outlier rates were specifically analyzed. RevMan 5.3 was used for the statistical analysis. Results Seven studies were included in the meta-analysis. Four studies reported both clinical and radiological outcomes, two reported only radiological outcomes, and one reported only clinical outcomes. The pooled analysis showed that the revision rate in the MP instrumentation group was 0.866 per 100 component years, while that in the control group was 1.124 (odds ratio, 0.77; p < 0.05). The subgroup analysis of the bearing dislocation rate showed a significantly greater reduction in the Korean population than in the populations of other countries (p < 0.05). The radiological assessment showed that the alignment of the femoral component was significantly improved (p < 0.05), while that of the tibial component was not (p > 0.05). Conclusion The newly developed MP instrumentation for Oxford UKA significantly reduced the revision rate of this treatment. The positioning of the femoral component was also proven to be better by radiological assessments.

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Bearing Dislocation and Progression of Osteoarthritis After Mobile-bearing Unicompartmental Knee Arthroplasty Vary Between Asian and Western Patients: A Meta-analysis

Abstract: Level III, therapeutic study.

Cited by 31 publications

References 52 publications

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

Curcumin reduces inflammation in knee osteoarthritis rats through blocking TLR4 /MyD88/NF‐κB signal pathway

Does new instrument for Oxford unicompartmental knee arthroplasty improve short-term clinical outcome and component alignment? A meta-analysis

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