Registry Outcomes of Unicompartmental Knee Arthroplasty Revisions

Dudley, Thomas E.; Gioe, Terence J.; Sinner, Penny J.; Mehle, Susan

doi:10.1007/s11999-008-0279-3

Cited by 61 publications

(59 citation statements)

References 23 publications

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“…Early survival studies of UKA demonstrated revision rates of 15% to 28% [23,34,44]. More recent articles report substantial increases in survival, with midterm survivorship for UKA of 84% to 98% (Table 1) [10,12,14,19,39,40,42,46,48,[57][58][59][60][61]. O'Rourke et al [43] followed by Price and Svard [49] documented long-term survival rates of UKA at 20 years of 84% and 91%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Satisfaction after either TKA or UKA is similar [54]. UKA has demonstrated survivorship of greater than 90% for more than 10 years after implantation in multiple studies [6,12,39,40,48,49,59]. The cumulative revision rate is higher for UKA than for conventional TKA, ranging from 82% to 98% at 5 to 22 years for UKA compared to 91% to 98.9% at 5 to 19 years for TKA (Table 1) [5, 6, 10, 12, 28-30, 33, 52].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Lyons

MacDonald

Somerville

et al. 2012

Clinical Orthopaedics &Amp; Related Research

231

140

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Background TKA and unicompartmental knee arthroplasty (UKA) are both utilized to treat unicompartmental knee arthrosis. While some surgeons assume UKA provides better function than TKA, this assumption is based on greater final outcome scores rather than on change in scores and many patients with UKA have higher preoperative scores. Questions/purposes We therefore asked whether TKA would demonstrate (1) better change in clinical outcome scores from preoperative to postoperative states and (2) better survivorship than UKA. Methods We evaluated 4087 patients with 5606 TKAs and 179 patients with 279 UKAs performed between 1978 and 2009. Patients with TKA were older and heavier than patients with UKA (mean age, 68 versus 66 years; mean BMI, 32 versus 29). We compared preoperative, latest postoperative, and change in Knee Society Clinical Rating System (KSCRS), SF-12, and WOMAC scores. Minimum followup was 2 years (UKA: mean, 7 years; range, 2.0-23 years; TKA: mean, 6.5 years; range, 2.0-33 years). Preoperative outcome measure scores (WOMAC, SF-12, KSCRS) were higher in the UKA group. Results Patients with UKA had higher postoperative KSCRS and SF-12 mental scores. Changes in score for all WOMAC domains were similar between groups. Total KSCRS changes in score were similar between groups, although patients with TKA had higher knee scores (49 versus 43) but lower function scores than UKA (21 versus 26). Cumulative revision rate was higher for UKA than for TKA (13% versus 7%). Kaplan-Meier survivorship at 5 and 10 years was 95% and 90%, respectively, for UKA and 98% and 95%, respectively, for TKA. Conclusions While patients with UKA had higher preand postoperative scores than patients with TKA, the changes in scores were similar in both groups and survival appeared higher in patients with TKA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Lyons

MacDonald

Somerville

et al. 2012

Clinical Orthopaedics &Amp; Related Research

231

140

View full text Add to dashboard Cite

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“…Some studies have looked at the influence of these factors at a given time and not the trend in a longitudinal manner [15,18]. Moreover, the studies may be biased by including cases with traditionally poorer scores (revision for infection) [2,5,16] or less complex procedures (polyethylene liner exchange, patellar resurfacing, revision for unicondylar knee replacement) [6,10]. The aim of this study was to investigate the patterns of recovery after aseptic revision TKA in a prospective, longitudinal analysis of patients who underwent surgery in a tertiary referral unit.…”

Section: Discussionmentioning

confidence: 99%

“…However, few published studies have reported predictors of function after revision knee replacement and are limited by small sample size and therefore limited power to examine predictors of poor functional scores [15,18]. The studies that have looked at predictors include revisions for indications like infection, which traditionally have a poorer outcome [2,5,16], and also revisions for lesser interventions like polyethylene liner exchange, patellar resurfacings, and revision of unicompartmental knee replacements, which would have better outcomes [6,10] . Moreover, other than for the study by Ghomrawi et al [8], these studies have looked at predictors of outcome at a given time (cross-sectional analysis), rather than the trend over a period of time (longitudinal analysis).…”

Section: Introductionmentioning

confidence: 99%

When Do Patient-reported Assessments Peak after Revision Knee Arthroplasty?

Malviya

Bettinson

Kurtz

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The best timing for patient visits after revision TKA is unclear. Predictors of pain and function reported in the literature typically look at the influence at a given time that might not be ideal if the score is not at a peak or the earliest possible time. Moreover, most reports of predictors include revisions for infection, which typically have a poorer outcome, or for other indications with variable outcome.Questions/purposes We therefore determined (1) the trend of recovery after revision TKA to determine the best time to measure the peak patient-reported pain and function scores and (2) the influence of comorbidities and age on the patterns of recovery. Methods We prospectively followed 120 patients who had revision TKAs from 2003 to 2008. The patients were assessed within 6 weeks before surgery and at 12 weeks, 1 year, and annually thereafter. We obtained WOMAC and SF-36 scores at each visit. We used a linear mixed model analysis to assess predictors. The minimum followup was 2 years (mean, 3 years; range, 2-7 years). Results The majority of improvements in the WOMAC and SF-36 scores occurred during the first year after surgery after which the scores stabilized. One of the seven independent preoperative variables studied (comorbidities) predicted a trend toward improvement of WOMAC pain, WOMAC function, and SF-36 bodily pain scores. The greater the numbers of comorbidities, the worse were the scores. Age, gender, BMI, indication for surgery, and surgeon did not independently influence the WOMAC or SF-36. Conclusion Our data suggest that one of the times for patient visits after revision TKA should be 1 year after surgery. This time allows for key discrimination of implant performance.

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“…On the other hand, they also noticed that knee scores recovered in UKA revision patients when posterior cruciate ligament substituting designs were used. UKA revision knee replacement is a demanding operation; however, opinions vary on how it relates to primary TKA or TKA revision [7,16]. Saragaglia et al [22] evaluated the radiological and clinical results of 33 medial UKA converted to TKA revisions.…”

Section: Discussionmentioning

confidence: 99%