High Rate of Early Revision After Custom-Made Unicondylar Knee Arthroplasty

Talmo, Carl T.; Anderson, Marie C.; Jia, Eliot S.; Robbins, Claire E.; Rand, Jason D.; McKeon, Brian

doi:10.1016/j.arth.2018.03.010

Cited by 9 publications

(17 citation statements)

References 27 publications

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“…These findings were not echoed by our study, or by Demange et al [ 26 ], who found a rate of 3% at 3.1 years in a prospective cohort of 33 lateral C-UKAs. The most common reason for revision reported by Talmo et al [ 30 ] was aseptic loosening (75.9%), which was a less common reason for revision in our study (14%). Their data do not suggest a clear reason for this discrepancy.…”

Section: Discussioncontrasting

confidence: 44%

“…Survivorship in C-UKA has only been reported by two previous studies. In 2018, Talmo et al [ 30 ] found a revision rate of 25.2% in a retrospective analysis of 115 medial C-UKAs at follow up of 4.5 years (average time to implant failure of 2.8 years). These findings were not echoed by our study, or by Demange et al [ 26 ], who found a rate of 3% at 3.1 years in a prospective cohort of 33 lateral C-UKAs.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown satisfactory radiographic outcomes [ 28 ], as well as satisfactory short-term clinical results [ 26 , 29 ]. Only one study, to the best of the authors’ knowledge, has investigated the outcomes of C-UKA at the mid-term follow-up [ 30 ]. The aim of the present study was to retrospectively analyze patient satisfaction, PROMs, and implant survivorship in a large patient cohort with C-UKA at the mid-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

Pumilia

Schroeder

Sarpong

et al. 2021

JPM

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Customized unicompartmental knee arthroplasty (C-UKA) utilizes implants manufactured on an individual patient basis, derived from pre-operative computed tomography images in an effort to more closely approximate the natural anatomy of the knee. The outcomes from 349 medial and lateral fixed-bearing C-UKA were reviewed. Implant survivorship analysis was conducted via retrospective chart review, and follow-up analysis was conducted via a single postoperative phone call or email. The rate of follow-up was 69% (242 knees). The average age at surgery was 71.1 years and the average body mass index was 28.8 kg/m2. Seven revision arthroplasties (2.1%) had knowingly been performed at an average of 1.9 years postoperatively (range: 0.1–3.9 years), resulting in an implant survivorship of 97.9% at an average follow-up of 4.2 years (range: 0.1–8.7) and 97.9% at an average of 4.8 years (range: 2.0–8.7) when knees with less than two years of follow-up were excluded. The reasons for revision were implant loosening (one knee), infection (two knees), progression of osteoarthritis (two knees), and unknown reasons (two knees). The average KOOS, JR. interval score was 84 (SD: 14.4). Of those able to be contacted for follow-up analysis, 67% were “very satisfied,” 26% were “satisfied,” 4% were “neutral,” 2% were “dissatisfied,” and 1% were “very dissatisfied.” When asked if the knee felt “natural,” 60% responded with “always,” 35% responded with “sometimes,” and 5% responded with “never.” After analyzing a large cohort of C-UKA, we found favorable rates of survivorship, satisfaction, and patient-reported functional outcomes.

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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

Pumilia

Schroeder

Sarpong

et al. 2021

JPM

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“…The way in which A&F is offered varies, from publicly available annual reports including only nationwide averages with sometimes additional surgeon-group-specific performance, whereas others publish their indicators on surgeon-group level and surgeon level only in password-protected online dashboards (Li et al 1999, Itonaga et al 2000, Tabak et al 2002, Bonutti et al 2017, Kurcz et al 2018, Talmo et al 2018, Assi et al 2019, Pelt et al 2019, Porter et al 2019, Yoon et al 2019. The LROI, National Joint Registry in the United Kingdom (NJR), and Swedish Hip Arthroplasty Registries (SHAR) use a web-based password-protected A&F dashboard to provide surgeons with peer-comparison indicators in visual graphs on surgeon-group level and in the United Kingdom also on surgeon level (Toomey et al 2001, Tabak et al 2002, Assi et al 2019, Porter et al 2019, Yoon et al 2019).…”

Section: Differences and Similarities Between National Arthroplasty Rmentioning

confidence: 99%

“…In this study, for instance, it was found that one-third of both THA and TKA surgeons do not know their 1-year revision rate, which may suggest that some surgeons do not recognize the importance of this outcome. This is striking because this outcome is already widely used by arthroplasty registries and considered an indicator to reflect the quality of care (Li et al 1999, Itonaga et al 2000, Tabak et al 2002, Bonutti et al 2017, Talmo et al 2018. Moreover, A&F does not use absolute benchmarks, but performance indicators are compared with national surgeongroup averages, thereby making it likely that other similar surgeon groups are able to achieve that level of performance.…”

Section: Comparison With Literaturementioning

confidence: 99%

Awareness of performance on outcomes after total hip and knee arthroplasty among Dutch orthopedic surgeons: how to improve feedback from arthroplasty registries

et al. 2020

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Background and purpose — The Netherlands Registry of Orthopedic Implants (LROI) uses audit and feedback (A&F) as the strategy to improve performance outcomes after total hip and knee arthroplasty (THA/TKA). Effectiveness of A&F depends on awareness of below-average performance to initiate improvement activities. We explored the awareness of Dutch orthopedic surgeons regarding their performance on outcomes after THA/TKA and factors associated with this awareness. Methods — An anonymous questionnaire was sent to all 445 eligible Dutch orthopedic surgeons performing THA/TKA. To assess awareness on own surgeon-group performance, they were asked whether their 1-year THA/TKA revision rates over the past 2 years were below average (negative outlier), average (non-outlier), above average (positive outlier) in the funnel plot on the LROI dashboard, or did not know. Associations were determined with (1) dashboard login at least once a year (yes/no); (2) correct funnel-plot interpretation (yes/no) and; (3) recall of their 1-year THA/TKA revision rate (yes/no). Results — 44% of respondents started the questionnaire, 158 THA and 156 TKA surgeons. 55% of THA surgeons and 55% of TKA surgeons were aware of their performance. Surgeons aware of their performance more often logged in on the LROI dashboard, more often interpreted funnel plots correctly, and more often recalled their revision rate. 38% of THA and 26% of TKA surgeons scored “good” on all 3 outcomes. Interpretation — Only half of the orthopedic surgeons were aware of their performance status regarding outcomes after THA/TKA. This suggests that to increase awareness, orthopedic surgeons need to be actively motivated to look at the dashboard more frequently and educated on interpretation of funnel plots for audit and feedback to be effective.

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Optimal intersurface stability for unicompartmental femoral component design with two pegs placed on the distal resection surface: 5 mm peg length increment and 10° peg inclination

Sun,

Li,

Zhao

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe present study aimed to identify the optimal design of the unicompartmental femoral component through parameter analysis and stability evaluation.MethodsA finite element (FE) analysis was applied to analyse and adjust the parameter combinations of the anterior tilt angle of the posterior condyle resection surface, the position of the peg, the length of the peg and the inclination angle of the peg, resulting in 10 different FE models. Setting three knee flexion angles of 8.4° (maximum load state during walking), 40° (maximum load state during stair climbing) and 90° (maximum load state during squatting exercise), quantitatively analysing the micromotion values of the bone–prosthesis interface and defining a weighted scoring formula to evaluate the stability of different FE models. The validity of the FE analysis was verified using the Digital Image Correlation (DIC) device.ResultsThe errors between the FE analysis and the DIC test at three flexion angles were 5.6%, 1.7% and 11.1%. The 10 different femoral component design models were measured separately. The FE analysis demonstrated that the design with a 0° anterior tilt angle of the posterior condyle resection surface, both pegs placed on the distal resection surface, lengthened 5 mm pegs and a 10° peg inclination angle provided the best stability.ConclusionThe current study proposed a method for evaluating the stability of the femoral component design. The optimal intersurface stability design of the unicompartmental femoral component was achieved with two pegs placed on the distal resection surface, a 5‐mm peg length increment and a 10° peg inclination. These results might provide a reference for the selection of unicompartmental femoral components in clinical practice and therefore improve the survival rate of future unicompartmental knee arthroplasty.Level of EvidenceLevel III.

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High Rate of Early Revision After Custom-Made Unicondylar Knee Arthroplasty

Cited by 9 publications

References 27 publications

Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

Awareness of performance on outcomes after total hip and knee arthroplasty among Dutch orthopedic surgeons: how to improve feedback from arthroplasty registries

Optimal intersurface stability for unicompartmental femoral component design with two pegs placed on the distal resection surface: 5 mm peg length increment and 10° peg inclination

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