Lateral unicompartmental knee arthroplasty is a safe procedure for post-traumatic osteoarthritis after lateral tibial plateau fracture: a case–control study at 10-year follow-up

Abstract

Purpose Very few studies focus on lateral unicompartmental arthroplasty (LUKA) in the setting of post-traumatic osteoarthritis (PTOA). The hypothesis of our study is that LUKA is an efective procedure for isolated lateral PTOA with similar outcomes to non-traumatic LUKA. Methods Between 1990 and 2016, eighteen LUKA performed for isolated lateral tibiofemoral osteoarthritis secondary to tibial plateau fracture were retrospectively reviewed (post-traumatic group) and matched with a control group of thirty-six LUKA performed for non-traumatic OA. Clinical (International Knee Score), radiological outcomes and revision rate were compared between the two groups with a minimum follow-up of three years. Results With a mean follow-up of 10.1 years, postoperative IKS scores were similar between the two groups (IKS Knee: 89.1 (control) versus 85 (p = 0.03) and IKS Function: 85.9 (control) versus 77.9 (n.s.). Clinical improvement was greater for the post-traumatic group. No diference was observed with regard to revision rate (3/18 (16.7%) cases in the post-traumatic group and 7/36 (19.4%) in the control group, n.s.) or polyethylene wear per year between the two groups. The revision freesurvival rate was 64.8% for the post-traumatic group and 58.8% for the control group at 22-year follow-up (n.s.). Conclusion LUKA is an efective procedure at long-term for patients sufering from isolated lateral PTOA with similar clinical and radiographic results compared to LUKA performed for non-traumatic OA and without increased risk of revision or prosthetic wear. Level of evidence IV.

Disease progression, aseptic loosening and bearing dislocations are the main revision indications after lateral unicompartmental knee arthroplasty: a systematic review

“…Data from 32 studies were available to compare mobile-bearing vs. fixed-bearing implants; 10 studies (n ¼ 2,268) with mobile-bearing implants [14,18,28,32,33,37,38,41,50,53], 18 studies (n ¼ 1,469) with fixed-bearing [8,26,[42][43][44][45][46][47][48][49]27,30,31,[34][35][36]39,40] and 4 additional studies that reported outcomes for both (n ¼ 1,743 mobile-bearing, n ¼ 790 fixed-bearing) [25,29,46,51]. 18 studies had a moderate risk of bias [8,18,[44][45][46][47][48][49][50]53,26,31,33,34,37,39,42,…”

“…Data from 15 studies reported the use of all-PE vs. metal-backed fixedbearing implants; 5 studies (n ¼ 267) with all-PE implants [25,34,36,40,53]; 10 studies (n ¼ 660) with metal-baked implants [8,26,27,29,39,[42][43][44][45][46]. Nine studies had a moderate risk of bias [8,26,34,39,[42][43][44][45][46] and six studies had a serious risk of bias [25,27,29,30,36,40].…”

“…Data from 15 studies reported the use of all-PE vs. metal-backed fixedbearing implants; 5 studies (n ¼ 267) with all-PE implants [25,34,36,40,53]; 10 studies (n ¼ 660) with metal-baked implants [8,26,27,29,39,[42][43][44][45][46]. Nine studies had a moderate risk of bias [8,26,34,39,[42][43][44][45][46] and six studies had a serious risk of bias [25,27,29,30,36,40]. For fixed-bearing implants, the incidence of revision was higher with the use of all-PE tibial components than metal-backed: 37 revisions were reported out of 267 all-PE implants (13.9% revised, 3.62 per 100 ocy, mean follow-up 4.8 years) compared with 12 revisions out of 660 metal-backed implants (1.8% revised, 0.42 per 100 ocy, mean follow-up 4.5 years; Table 4).…”

Survival of lateral unicompartmental knee arthroplasty at short‐, mid‐, and long‐term follow‐up: a systematic review and meta‐analysis

“…Two thousand one hundred and sixty studies were then screened for eligibility based on their titles and abstracts. After a screening and retrieval process, 40 articles received a full‐text evaluation for eligibility and finally, 26 studies 7–9,15–37 were included in this meta‐analysis. Detailed information regarding study selection is displayed in Figure 1.…”

Radiographic Evidence of Early Posttraumatic Osteoarthritis following Tibial Plateau Fracture Is Associated with Poorer Function

“…39 Recent studies have demonstrated that primary UKA and secondary UKA for PTOA both provide excellent outcomes and have similar complication rates and long-term survivorship (>90%). 40 41…”