Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement

Kuipers, Bart M.; Kollen, Boudewijn J.; Bots, Peter C. Kaijser; Burger, Bart J.; Raay, Jos J. A. M. van; Tulp, Niek J. A.; Verheyen, Cees C. P. M.

doi:10.1016/j.knee.2009.07.005

Cited by 129 publications

(82 citation statements)

References 26 publications

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“…An important characteristic of the posttraumatic population in our series is that the prior tibial plateau fracture led to the development of arthritis and subsequent UKA at a younger age (mean, 50 years) than the mean age reported in series utilizing UKA for lateral compartment degenerative disease (61-72 years) [2,3,16,21,23]. The functional demands of these younger patients theoretically increases their failure risk in the medium and long term, as has been noted in medial UKA [14,15]. In spite of this concern, we noted no evidence of substantial polyethylene wear or implant loosening and implant survival was comparable to that in published series.…”

Section: Discussionmentioning

confidence: 77%

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lustig

Parratte

Magnussen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Posttraumatic arthritis secondary to lateral tibial plateau fracture malunion causes pain and limited function for patients. It is sometimes technically challenging to correct malalignment in these patients with advanced arthritis using osteotomies. Lateral unicompartmental knee arthroplasty (UKA) may be an option to treat such patients. Questions/purposes We asked whether UKA for lateral posttraumatic osteoarthritis (1) reliably alleviates pain and improve function, (2) restores lower limb alignment, and (3) is as durable as UKA for primary lateral osteoarthritis. Patients and Methods We retrospectively reviewed 13 patients with lateral cemented UKA (mean age at surgery, 50.1 years) treated at two institutions between 1985 and 2007. We obtained Knee Society scores and evaluated radiographs for evidence of implant loosening or progression of arthritis in the medial compartment. Minimum followup was 3 years (mean, 10.2 years; range, 3-22.1 years). Results Mean Knee Society knee score improved from 51 points (range, 29-75 points) preoperatively to 88 points (range, 65-100 points) at last followup, suggesting the procedure relieved pain. Mean function score improved from 51 points (range, 10-89 points) preoperatively to 87 points (range, 35-100 points) at last followup. The mean hip-knee-ankle angle was 188°preoperatively (range, 184°-1938) and 185°(range, 183°-188°) at last followup. Prosthesis survivorship was 100% at 5 and 10 years and 80% at 15 years.

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Section: Discussionmentioning

confidence: 77%

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lustig

Parratte

Magnussen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…One study reported a 5-year survival rate of just 84.7% in 437 knees. 8 Patients aged <60 years had 2.2-fold increased risk of revision than those who were older. 8 Younger age was a predictor of failure; the mean age of their cohort was 60 years.…”

Section: Discussionmentioning

confidence: 99%

“…Age, weight, or the presence of patellofemoral arthritis were not contraindications to surgery. 8 An incision was made from the medial pole of the patella to the medial aspect of the tibial tuberosity. 23 All implants were balanced in extension and flexion, and checked to ensure that there was no impingement upon the bearing throughout a full range of movement.…”

Section: Methodsmentioning

confidence: 99%

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Medium-Term Results of Oxford Phase-3 Medial Unicompartmental Knee Arthroplasty

Clement

Duckworth

MacKenzie

et al. 2012

J Orthop Surg (Hong Kong)

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purpose. To review medium-term results of 49 consecutive patients who underwent Oxford phase-3 medial unicompartmental knee arthroplasty by a single surgeon. Methods. Records of 28 women (mean age, 71 years) and 21 men (mean age, 68 years) who underwent minimally invasive Oxford phase-3 medial unicompartmental knee arthroplasty by a single surgeon were retrospectively reviewed. The Oxford knee score and visual analogue scale (VAS) scores for pain and satisfaction were assessed at the latest follow-up by an independent observer, as were postoperative radiographs for implant position, osteoarthritic changes in the non-replaced compartments, and radiolucent lines of >2 mm or implant subsidence. The survival rate was calculated using Kaplan-Meier survival analysis. Patient demographics, postoperative alignment (varus/ valgus), Oxford knee scores, and the progression of osteoarthritis in the other compartments were included in a multiple logistic regression (MLR) analysis to identify significant factors affecting the probability of being satisfied (VAS scores for satisfaction of ≤2). results. The mean follow-up duration was 7.2 years. Medium-term results of Journal of Orthopaedic Surgery 2012;20(2):157-61No patient was lost to follow-up. Two patients with no knee symptoms died (unrelated to surgery) before the 5-year follow-up. The cumulative survival rate at the 9-year follow-up was 91.2% (95% confidence interval, 87.6-94.5%). There were 4 early failures (before 4 years). One patient early in the series developed avascular necrosis of the lateral femoral condyle with an over-corrected tibiofemoral valgus of 12º at 8 months; the other 3 complained of anterior knee pain, without signs of osteoarthritis. All 4 patients underwent revision with total knee arthroplasty. There were 43 patients with more than 5 years of follow-up and without revision of the prosthesis. Patients who were not satisfied (n=6) were more likely to be <65 years old (n=4, adjusted odds ratio [OR], 3.1; MLR p=0.002) and male (n=4; adjusted OR, 2.3; MLR p=0.02). Six of the 43 patients had lucent lines on radiographs, all of which were partial and under the tibial component. Progression of the arthritis in the patellofemoral and/or lateral compartments was worse in 5 patients. conclusion. Careful patient selection and good surgical technique contributed to good outcome. Younger male patients should be counselled regarding the higher chance of limited satisfaction.

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“…However, survivorship after unicompartmental arthroplasty is often lower than that after TKA [6,7]. Loosening, lysis, and wear and polyethylene damage continue to be important factors affecting outcomes and have been implicated in up to 22% to 45% of revision surgeries after UKA [8,9].…”

mentioning

confidence: 99%

Effect of Polyethylene Crosslinking and Bearing Design on Wear of Unicompartmental Arthroplasty

Netter¹,

Hermida²,

D'Alessio³

et al. 2015

The Journal of Arthroplasty

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Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement

Cited by 129 publications

References 26 publications

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Lateral Unicompartmental Knee Arthroplasty Relieves Pain and Improves Function in Posttraumatic Osteoarthritis

Medium-Term Results of Oxford Phase-3 Medial Unicompartmental Knee Arthroplasty

Effect of Polyethylene Crosslinking and Bearing Design on Wear of Unicompartmental Arthroplasty

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