Fixed-bearing unicompartmental knee arthroplasty provides a lower failure rate than mobile-bearing unicompartimental knee arthroplasty when used after a failed high tibial osteotomy: a systematic review and meta-analysis

Morales-Ávalos, Rodolfo; Perelli, Simone; Raygoza-Cortez, Karina; Padilla-Medina, José Ramón; Peña‐Martínez, Víctor M.; Guzmán-López, Santos; Zavala, José M. Diabb; Barrera, Francisco J.; Vílchez-Cavazos, Félix; Monllau, Juan Carlos

doi:10.1007/s00167-021-06707-4

Cited by 3 publications

(5 citation statements)

References 52 publications

(129 reference statements)

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Section: Introductionmentioning

confidence: 99%

“…Mobile bearing (MB) and fixed bearing (FB) implants are available for PKA [ 8 ]. The polyethylene insert in FB implants is secured on the metal tibial plateau, allowing flexion, extension, and roll back [ 8 ]. On the contrary, in MB implants, the polyethylene inlay is movable on is frontal axis, allows some degree of rotation of the tibia over the femur [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The polyethylene insert in FB implants is secured on the metal tibial plateau, allowing flexion, extension, and roll back [ 8 ]. On the contrary, in MB implants, the polyethylene inlay is movable on is frontal axis, allows some degree of rotation of the tibia over the femur [ 8 ]. Differences in stress distribution might lead to a difference in the outcome; however, previous evidence suggested that MB and FB promote similar outcome in PKA [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…On the contrary, in MB implants, the polyethylene inlay is movable on is frontal axis, allows some degree of rotation of the tibia over the femur [ 8 ]. Differences in stress distribution might lead to a difference in the outcome; however, previous evidence suggested that MB and FB promote similar outcome in PKA [ 8 , 11 ]. However, to the best of our knowledge, whether MB performs better than FB implants in octogenarians has not been evaluated in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

“…Previous meta-analyses reported that PKA promotes higher patient reported outcome measures (PROMs) compared to total knee arthroplasty [5], along with faster surgical duration, lower estimated blood lost and quicker hospitalization length. Kozinn and Scott in 1989 firstly defined the indications to perform a PKA [6]: monocompartimental osteoarthritis with efficient anterior cruciate ligament, varus deformity less than 5°, minimum range of motion of 90° without flexion contracture, Body Mass Index (BMI) < 30 kg/m 2 [7][8][9][10]. However, these recommendations are becoming obsolete and indications are extending also to additional settings [7].…”

Section: Introductionmentioning

confidence: 99%

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No difference in mobile and fixed bearing partial knee arthroplasty in octogenarians: a clinical trial

D’Ambrosi

Valli

Nuara

et al. 2023

Eur J Orthop Surg Traumatol

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Background A clinical trial comparing MB (mobile-bearing) versus FB (fixed-bearing) in medial partial knee arthroplasty (PKA) in octagenarians has been conducted. The focus of the present study was on PROMs, range of motion (ROM), implant positioning and implants survivorship. The hypothesis of the present study was that MB implants performed better than FB in PKA in octogenarians. Methods The first group received FB PKA-PPK®; the second received MB PKA-Oxford. Patients were not randomly allocated. The following PROMs were administered at T0 (pre-operatively), T1 (1 year after surgery), and T2 (3 years after surgery): visual analogue scale (VAS), Knee Society Score (KSS) and Oxford Knee Score (OKS). Data regarding the implant survivorship and ROM were also collected. Furthermore, the following radiographic parameters were measured: Femoral component varus/valgus; Tibial component varus/valgus; Anteroposterior slope. Results At T0, 28 patients were included in the FB and 33 in the MB group. The surgical time was shorter in the FB group (p < 0.001). No difference between FB and MB in ROM, VAS, KSS, and OKS at each follow-up (p > 0.05). No difference was found in implant positioning (p > 0.05). At last follow-up, FB group reported three failures caused by aseptic loosening. Four failures were observed in the MB cohort: two for bearing dislocation and two for aseptic loosening. The Kaplan–Meier Curve found no differences in implant survivorship. Conclusions According to the main findings of the present clinical trial, MB implants performed similar to FB in PKA in octogenarians. The FB group demonstrated shorted surgical time. No difference was found in patient reported outcome measures, ROM, implant positioning, and survivorship. Level of evidence Level II, prospective study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

No difference in mobile and fixed bearing partial knee arthroplasty in octogenarians: a clinical trial

D’Ambrosi

Valli

Nuara

et al. 2023

Eur J Orthop Surg Traumatol

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Arthroplastie unicompartimentale interne après ostéotomie tibiale de valgisation : une série rétrospective de 41 cas

Chan-Waï-Nam

Fernandez

Josse

et al. 2023

Revue de Chirurgie Orthopédique et Traumatologique

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Medial unicompartmental knee replacement is a viable treatment option after failed high tibial osteotomy: a systematic review

Legnani

Parente

et al. 2022

EFORT Open Reviews

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Purpose It is debatable whether or not previous high tibial osteotomy (HTO) has negative effects on the results of subsequent medial unicompartmental knee replacement (UKR). The purpose of this study is to report, through a systematic review of the literature, the outcomes of medial UKR after failed HTO. It was hypothesized that this procedure would be safe and effective in providing satisfactory postoperative functional outcomes. Methods A systematic review was performed by searching Pubmed/MEDLINE, Embase and CINAHL. Only studies in English pertaining to all levels of evidence reporting on subjects undergoing UKR following HTO were considered. Review articles and expert opinion or editorial pieces were excluded. Outcomes of interest included indications, surgical technique and associated procedures, type of prosthesis, clinical and functional outcomes, rate of complications, revision surgery and failure rate. Results Overall, six studies met all the inclusion criteria for this review. All were published between 2006 and 2021. The search resulted in one prospective comparative study, four retrospective comparative cohort studies, and one retrospective cohort study. Average follow-up periods ranged from 1 to 13 years. From these studies, 115 patients (117 knees) were identified. Overall, most studies reported satisfying postoperative clinical and functional outcomes. Implant survivorship ranged from 66 to 97.6%. In 15 patients, revision surgery was performed due to persistent pain. Conclusions Medial UKR performed after failed HTO appears as a feasible procedure providing satisfying outcomes and limited complications in most cases. Further prospective comparative studies reporting long-term outcomes are needed, as high-level studies on this topic are lacking.

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Fixed-bearing unicompartmental knee arthroplasty provides a lower failure rate than mobile-bearing unicompartimental knee arthroplasty when used after a failed high tibial osteotomy: a systematic review and meta-analysis

Cited by 3 publications

References 52 publications

No difference in mobile and fixed bearing partial knee arthroplasty in octogenarians: a clinical trial

No difference in mobile and fixed bearing partial knee arthroplasty in octogenarians: a clinical trial

Arthroplastie unicompartimentale interne après ostéotomie tibiale de valgisation : une série rétrospective de 41 cas

Medial unicompartmental knee replacement is a viable treatment option after failed high tibial osteotomy: a systematic review

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