Is Mobile-Bearing Medial Unicompartmental Knee Arthroplasty Appropriate for Asian Patients With the Risk of Bearing Dislocation?

Kang, Suk-Woong; Kim, Kyung‐Taek; Hwang, Youn-Soo; Park, Won-Ro; Shin, Jong-Ki; Song, Moo Ho

doi:10.1016/j.arth.2019.12.036

Cited by 13 publications

(21 citation statements)

References 17 publications

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“…However, various methods were used and could not be pooled together for analysis. Nevertheless, all three studies from Korea showed that MP instrumentation could significantly reduce the bearing dislocation rate [8,12,18].…”

Section: Discussionmentioning

confidence: 97%

“…However, because MP instrumentation has been used in clinical practice for only 6 to 8 years, very few reports met our standards. We identified only 13 eligible articles for our study [7][8][9][10][11][12][13][14][15][16][17][18][19]. After scrutinizing the full text, we excluded three articles not written in English [7,16,17], two articles by the same authors and describing the same patient group [14,15], and one article in which the complications were not fully reported [18].…”

Section: Study Selectionmentioning

confidence: 99%

“…We identified only 13 eligible articles for our study [7][8][9][10][11][12][13][14][15][16][17][18][19]. After scrutinizing the full text, we excluded three articles not written in English [7,16,17], two articles by the same authors and describing the same patient group [14,15], and one article in which the complications were not fully reported [18]. Finally, seven articles were included in the meta-analysis [8][9][10][11][12][13]19].…”

Section: Study Selectionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 97%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…In a recently published systematic review of Oxford Phase III UKA, Ro et al [4] found that Asian patients had a higher dislocation rate than Western patients because of their traditional lifestyle and religious practices, which involve the sitting kneel position or cross-leg sitting. However, whether this fact applies to all East Asian populations remains debatable [4][5][6][7][8][9]. In this review, we focused only on patients from East Asia who shared similar lifestyle practices involving regular knee hyperflexion to identify differences among countries.…”

Section: Introductionmentioning

confidence: 99%

“…Some researchers have recently suggested that bearing dislocation usually happens shortly after primary UKA because of errors in this procedure [4,5,10]. In contrast, some other researchers have shown that bearing dislocation can occur long after the primary operation, indicating that the direct cause might be bearing wear [6,11]. Because few studies have investigated the mechanism of bearing dislocation, which is even more difficult to review by a meta-analysis, we evaluated the time interval between dislocation and the primary operation to accumulate more evidence.…”

Section: Introductionmentioning

confidence: 99%

Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis

Sun

Liu

et al. 2021

J Orthop Surg Res

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Background Bearing dislocation is a common postoperative complication of mobile-bearing unicompartmental knee arthroplasty, and East Asian patients tend to be at higher risk. However, whether this high dislocation rate is common in all East Asian populations remains unclear. This meta-analysis was performed to explore this issue and describe various features of dislocation in East Asians, including the onset time, dislocation direction, and re-dislocation rate. Methods The literature was searched in PubMed, Embase, Ovid, and Cochrane Library up to May 2020. Studies were scrutinized by two independent authors, and the bearing dislocation rate, onset time, direction, and re-dislocation rate were specifically analyzed. RevMan 5.3 was used for the statistical analysis. Results Seven case series from Korea, China, and Japan were included. The pooled analysis showed that the total dislocation rate was 2.37%, while the subgroup analysis showed that the dislocation rate in Korea and other countries was 4.50% and 0.74%, respectively (P < 0.01). Another subgroup analysis of the onset time showed a significant difference before and after the first 5 years postoperatively (P < 0.01). Anterior and posterior dislocations were more frequent than medial and lateral dislocations (P < 0.01). The average re-dislocation rate was 32.45%, which was approximately seven times higher than the primary dislocation rate (P < 0.01). Conclusion Our meta-analysis demonstrated that Korea had a higher bearing dislocation rate among East Asian countries, especially in the first 5 years after primary UKA. Anterior and posterior dislocations were common. The most important finding is that the re-dislocation rate can be much higher than the initial dislocation rate.

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Approximately 41% of knees have a looser gap in full extension than in 20° flexion after Oxford unicompartmental arthroplasty

Araki

Hiranaka

Okimura

et al. 2022

Arch Orthop Trauma Surg

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Is Mobile-Bearing Medial Unicompartmental Knee Arthroplasty Appropriate for Asian Patients With the Risk of Bearing Dislocation?

Cited by 13 publications

References 17 publications

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

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

Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis

Approximately 41% of knees have a looser gap in full extension than in 20° flexion after Oxford unicompartmental arthroplasty

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