Prothèses unicompartimentales médiales du genou : influence des paramètres de pose du composant tibial sur les résultats cliniques et la survie

Chatellard, R.; Sauleau, V.; Colmar, M.; Robert, H.; Raynaud, G; Brilhault, J.

doi:10.1016/j.rcot.2013.03.005

Cited by 7 publications

(10 citation statements)

References 23 publications

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“…Poor outcomes have been previously associated with more than 7 degrees of posterior slope. 31,37 Therefore, we think that further research is necessary to determine whether recreation of the preoperative posterior slope for Asian populations is ideal or not. Judging from our results that group 1 (average posterior slope was 6.0 degrees) achieved excellent clinical results including deep flexion angle, a tibial slope of approximately 7 degrees which many surgeons target routinely, might be reasonable.…”

Section: Discussionmentioning

confidence: 99%

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Necessary Factors to Achieve Deep Flexion for Asian Populations after Oxford Unicompartmental Knee Arthroplasty

et al. 2019

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There have been many reports on the clinical outcomes of Oxford unicompartmental knee arthroplasty (UKA); however, none have investigated the influence of flexion angle after UKA on clinical outcomes. The objective of this study was to clarify the relationship between outcomes and the postoperative maximum flexion angle and reveal the necessary factors for maximum flexion angle ≥ 140 degrees which is considered necessary for Asian populations. We categorized 212 UKA patients into the following three groups based on the postoperative maximum flexion angle: group 1 had flexion angle ≥ 140 degrees in 80 patients (38%), group 2 had 130 degrees ≤ flexion angle < 140 degrees in 80 patients (38%), and group 3 had flexion angle < 130 degrees in 52 patients (24%). Furthermore, we compared the postoperative clinical outcomes between the three groups and conducted multivariable regression analyses to assess parameters affecting the flexion angle. Postoperative Knee Society function scores for group 1 was significantly higher than for group 3. Group 1 had higher mean knee injury and osteoarthritis outcome scores (KOOS) in all subscales and significantly higher KOOS scores in the sports and quality of life subscales compared with group 2 and in all subscales compared with group 3. Multivariable logistic regression showed that preoperative flexion angle and tibial component posterior slope were associated with maximum flexion angle ≥ 140 degrees. Maximum flexion angle ≥ 140 degrees after Oxford UKA improved the clinical results, particularly for patient-reported outcomes. Furthermore, the tibial posterior slope was an important factor in achieving maximum flexion angle ≥ 140 degrees in UKA patients.

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Section: Discussionmentioning

confidence: 99%

“…However, more than 2 degrees of posterior slope change has been reported to increase the risk of dislocation and shorter prosthesis survival. 8,37 Further long-term study is needed to establish the optimal postoperative tibial slope and acceptable tibial slope change, in particular, for Asian populations.…”

Section: Discussionmentioning

confidence: 99%

Necessary Factors to Achieve Deep Flexion for Asian Populations after Oxford Unicompartmental Knee Arthroplasty

et al. 2019

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“…However, absence of ligament distension with load transfer to the prosthetic plateau may result in tibial component loosening. 2 An excessive slope should be avoided to optimize stress distribution. Therefore, implantation of the tibial component is recommended with a mild undercorrection of varus deformity while maintaining a posterior slope similar to the pre-pathological condition.…”

Section: Discussionmentioning

confidence: 99%

Mid-Term Clinical Outcome and Reconstruction of Posterior Tibial Slope after UKA

et al. 2018

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Unicompartmental knee arthroplasty (UKA) has gained growing popularity over the last decades. The posterior tibial slope (PTS) has been shown to play a significant role for knee biomechanics and is thought to be crucial for clinical function of the UKA. We evaluated the clinical outcome at mid-term follow-up after UKA. Furthermore, the reconstruction of the individual PTS was analyzed. A total of 91 consecutive patients undergoing medial UKA for osteoarthritis were included. Patients were contacted by telephone for a survival analysis at a minimum of 30 months after surgery. Patient-oriented questionnaires and Knee Osteoarthritis Outcome Score (KOOS) were obtained. A retrospective chart review and radiological analysis of component alignment were performed for all patients before and at 6 weeks after surgery. Of 91 patients (93 knees) undergoing UKA, 69 patients (70 knees) were available for clinical follow-up after a mean of 56.0 (range 31-81) months post-surgery. The clinical results of the examined patients in the present study showed mean subscale scores of the KOOS and Western Ontario and McMaster Universities Osteoarthritis Index between 71 and 91%. Overall 7 of 91 patients were revised during the course of follow-up period and underwent total knee arthroplasty. A Kaplan-Meier analysis showed a survival rate for UKA of 90.5% after 48 months. Calculated implant survival was 75.9 months (95% confidence interval 72.3-79.6) at the mean. The radiographic analysis of pre- and postoperative PTS showed no differences ( = 0.113).UKA for osteoarthritis of the medial knee compartment shows encouraging clinical results at mid-term follow-up. The individual PTS could be reconstructed within acceptable ranges. This is a retrospective therapeutic study with Level IV.

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“…Such studies found that, with regard to coronal alignment, change of tibial varus obliquity were associated with implant survivorship. 15,16 Taken together, these data indicate that varus alignment of tibial component with 2 or 3 degrees, which recreates the natural inclination of tibial joint surface, may have positive effects on clinical outcomes. Importantly, to the best of our knowledge, our data are the first report to support this hypothesis based on the postoperative PRO.…”

Section: Discussionmentioning

confidence: 76%

Implant Alignment and Patient Factors Affecting the Short-Term Patient-Reported Clinical Outcomes after Oxford Unicompartmental Knee Arthroplasty

et al. 2020

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This study aims at clarifying implant alignment and other patient factors' influence on clinical outcomes, particularly on patient-reported outcomes (PRO), following Oxford unicompartmental knee arthroplasty (OUKA). A total of 142 patients after OUKA were divided into two groups according to the validated Japanese version of the knee injury and osteoarthritis outcome score (KOOS) for each subscale of pain, symptoms, and activities of daily living (ADL) at postoperative year 1 and 2: group 1 had ≥80 scores and group 2 had <80 scores. Postoperative clinical and radiographical findings were then compared among groups in each subscale. Using postoperative year 1 and 2 data, a multivariable logistic regression analysis was conducted to clarify factors for clinical outcomes' improvement. In the analysis of KOOS subscale of symptoms at postoperative year 1, gender distribution, preoperative body mass index, and postoperative maximum knee flexion angles differed significantly among groups. In the analysis for KOOS subscale of ADL, significant differences were observed in postoperative tibial component varus angles. Multivariable logistic regression analysis revealed that all of these parameters significantly related to ≥80 KOOS scores of each subscale at postoperative year 1. Additionally, at postoperative year 2, larger postoperative knee flexion angles and tibial component varus angles related to ≥80 KOOS subscale of symptoms and ADL were observed. In conclusion, tibial component's larger varus alignment was associated with the better PRO at both 1 and 2 years after OUKA. Importantly, larger postoperative knee flexion angle helped achieve good short-term PRO after OUKA.

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Prothèses unicompartimentales médiales du genou : influence des paramètres de pose du composant tibial sur les résultats cliniques et la survie

Cited by 7 publications

References 23 publications

Necessary Factors to Achieve Deep Flexion for Asian Populations after Oxford Unicompartmental Knee Arthroplasty

Necessary Factors to Achieve Deep Flexion for Asian Populations after Oxford Unicompartmental Knee Arthroplasty

Mid-Term Clinical Outcome and Reconstruction of Posterior Tibial Slope after UKA

Implant Alignment and Patient Factors Affecting the Short-Term Patient-Reported Clinical Outcomes after Oxford Unicompartmental Knee Arthroplasty

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