Patellar height after unicompartmental knee arthroplasty: comparison between fixed and mobile bearing

D’Ambrosi, Riccardo; Buda, Matteo; Nuara, Alessandro; Mariani, Ilaria; Scelsi, Michele; Valli, Federico; Ursino, Nicola; Hirschmann, Michael T.

doi:10.1007/s00402-021-04183-6

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…For the medial component, fixed‐bearing medial PPK (Zimmer‐Biomet, Warsaw, Indiana, USA) was used. This implant has been already evaluated in a previous clinical trial of the same group, with similar improvement in the OKS at a 3‐year follow‐up [10]. The same implant was used in another study on 460 patients [56].…”

Section: Discussionmentioning

confidence: 99%

No difference in Oxford Knee Score between medial and lateral unicompartmental knee arthroplasty after two years of follow‐up: a clinical trial

Migliorini,

Cocconi,

Prinz

et al. 2023

J. exp. orthop.

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Purpose In patients with monocompartmental knee osteoarthritis, unicompartmental knee arthroplasty (UKA) can be performed. This study compared the medial versus lateral UKA in patients with monocompartimental knee arthroplasty. It was hypothesised that both implants achieve a similar outcome in OKS. Methods The UKAs were fixed-bearing medial PPK (Zimmer-Biomet, Warsaw, Indiana, USA) and fixed-bearing lateral Zuk (Lima Corporate, Udine, Italy). An intraarticular drain was placed and removed on the first postoperative day. Enoxaparin sodium 4000 units subcutaneously daily for 45 days was used as thromboembolic prophylaxis. The Italian version of the OKS was used for the clinical assessment. The following complications were also recorded: anterior knee pain, infection and revision surgeries. Results Data from 203 patients were collected. The mean age of the patients was 68.9 ± 6.7 years and the mean BMI was 28.1 ± 4.1 kg/m2. The mean OKS on admission was 22.1 ± 4.5 points. On admission, women, patients older than 70 years, and those with a BMI lower than 28 kg/m2 who underwent lateral UKA evidenced lower OKS. At the last follow-up, 26.7 and 26.9 months for the lateral and medial UKA, respectively, no between groups difference in OKS was evidenced. No patients experienced complications. Conclusion Medial and lateral UKA achieve similar outcomes in OKS at a minimum of two years of follow-up.

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Section: Discussionmentioning

confidence: 99%

No difference in Oxford Knee Score between medial and lateral unicompartmental knee arthroplasty after two years of follow‐up: a clinical trial

Migliorini,

Cocconi,

Prinz

et al. 2023

J. exp. orthop.

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“…Both IS and CD are validated and well-known methods to evaluate patellar height [ 55 – 57 ]. Different methods to measure patellar height have been developed over time [ 33 , 58 , 59 ]. Verhulst et al [ 38 ] found that the IS ratio but not the CD ratio was associated with a high intra- and inter-observer reliability.…”

Section: Discussionmentioning

confidence: 99%

“…Other acquired risk factors for patellar height changes following TKA have been described, including removal of Hoffa’s fat pad, scar tissue formation, intraoperative over-resection of the distal femur, and the type of surgical approach [ 27 – 32 ]. However, evidence on patellar height changes following UKA is lacking [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Change in patellar height in medial and lateral unicompartmental knee arthroplasty: a clinical trial

D’Ambrosi,

Rubino,

Ursino

et al. 2023

Arch Orthop Trauma Surg

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Introduction Evidence on patellar height changes following unicompartmental knee arthroplasty (UKA) is lacking. Therefore, this study compared the patella height in patients who underwent medial versus lateral UKA. Moreover, a subgroup analysis was conducted to investigate whether sex, age, and BMI of the patients exert an influence on the postoperative patellar height. Methods Radiographs and hospital records of patients undergoing UKA were prospectively collected. Surgeries were performed by one author with long experience in UKA in a highly standardised fashion. The implants were fixed-bearing medial PPK (Zimmer Biomet, Warsaw, Indiana, USA) and fixed-bearing lateral ZUK (Lima Corporate, Udine, Italy). The patellar height was measured using the Insall–Salvati and Caton–Deschamps indices. Results A total of 203 patients were included: 119 patients were included in the medial and 84 in the lateral UKA. The mean age of the patients was 68.9 ± 6.7 years, and the mean BMI was 28.1 ± 4.1 kg/m2. 54% (110 of 203 patients) were women. On admission, between-group comparability was found in age, BMI, sex, and length of the follow-up. No between-group and within-group difference was detected pre- and post-operatively in the Insall–Salvati and Caton–Deschamps indices in patients who have undergone medial versus lateral UKA. Concerning the subgroup analyses, no between-group and within-group difference was detected pre- and post-operatively in all comparisons according to sex, age, and BMI. Conclusion No difference was found in patella height in patients who have undergone medial compared to lateral UKA. Furthermore, there was no evidence of an association between patient characteristics (sex, age, BMI) and patella height between medial and lateral UKA.

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“…High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are widely used in the treatment of medial unicompartmental knee OA. [ 7 , 8 ] HTO and UKA differ in terms of concept. HTO is designed to increase the life span of articular cartilage by unloading and redistributing the mechanical forces over the unaffected compartment, while UKA is introduced to resurface the degenerative compartment and preserve the unaffected compartment.…”

Section: Introductionmentioning

confidence: 99%

“…[ 15 ] Nevertheless, with improvements in operative techniques and the quality of the implants, UKA could also obtain a good response to its activity. [ 5 , 7 ] It is difficult for surgeons to decide which one is more suitable for patients with medial unicompartmental OA.…”

Section: Introductionmentioning

confidence: 99%

Unicompartmental knee arthroplasty is superior to high tibial osteotomy for the treatment of medial unicompartmental osteoarthritis: A systematic review and meta-analysis

Huang

Wei

et al. 2022

Medicine

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Background: Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are widely used for the treatment of medial unicompartmental knee osteoarthritis (OA). However, the best approach remains controversial. This study aimed to present a systematic review and a meta-analysis to directly compare the clinical outcomes between HTO and UKA. We hypothesized that the clinical outcomes after UKA and HTO would be similar.Methods: Electronic databases (Web of Science, PubMed, Embase, CENTRAL, and Biosis Preview) were searched for related studies published before November 30, 2021. Retrospective and prospective studies that directly compared the postoperative outcomes between UKA and HTO were included. Odds ratio (ORs) and 95% confidence interval (CIs) for complications, revision to total knee arthroplasty (TKA), and weighted mean difference (MD) and 95% CIs in range of motion (ROM), pain, walking speed and function score were evaluated. Two reviewers independently assessed the quality of the studies. Subgroup and sensitivity analyses were performed to explore the heterogeneity.Results: Twenty-three retrospective and 6 prospective studies were included. A total of 3004 patients (3084 knees) were evaluated for comparison. Complications (OR, 4.88, 95% CI: 2.92-6.86) were significantly greater in the HTO group than in the UKA group. Postoperative function scores including Lysholm score (MD, −2.78, 95% CI: −5.37 to −0.18) and Hospital for Special Surgery (HSS) score (MD, −2.80, 95% CI: −5.39 to −0.20) were significantly lower in the HTO group than the UKA group. The postoperative ROM was similar between HTO and mobile-bearing UKA (MD, −3.78, 95% CI: −15.78 to 8.22). However, no significant differences were observed between the HTO and UKA group in terms of postoperative pain, walking speed, and revision to TKA.Conclusions: UKA is superior to HTO in minimizing complications and enhancing postoperative function scores. Mobilebearing UKA has a similar ROM compared with HTO. Both HTO and UKA provide satisfactory clinical outcomes in terms of walking speed, relieving pain, and revision to TKA. UKA appears to be more suitable for the elderly, and both mobile-bearing UKA and HTO are viable surgical options for younger active individuals.

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Patellar height after unicompartmental knee arthroplasty: comparison between fixed and mobile bearing

Cited by 5 publications

References 40 publications

No difference in Oxford Knee Score between medial and lateral unicompartmental knee arthroplasty after two years of follow‐up: a clinical trial

No difference in Oxford Knee Score between medial and lateral unicompartmental knee arthroplasty after two years of follow‐up: a clinical trial

Change in patellar height in medial and lateral unicompartmental knee arthroplasty: a clinical trial

Unicompartmental knee arthroplasty is superior to high tibial osteotomy for the treatment of medial unicompartmental osteoarthritis: A systematic review and meta-analysis

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