Results of Unicompartmental Knee Arthroplasty With Cemented, Fixed-Bearing Prosthesis Using Minimally Invasive Surgery

Biswal, Sandeep; Brighton, Roger

doi:10.1016/j.arth.2009.06.017

Cited by 32 publications

(26 citation statements)

References 32 publications

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“…Our results compare favorably to an earlier study 2 on Repicci II that reported a revision rate of 22% at 9 years in a series of 114 procedures implanted using MIS and a short-stay protocol, with 41% of patients discharged the same day as surgery. Others have reported similar revision rates (7.8%) in cemented fixed-bearing UKA (N ¼ 128) at an average follow-up of 6 years, 20 whereas a larger series (N ¼ 512) with a cementless design reported a revision rate of 2% (compared with this series at 4.5%) at 5 years 21 and secure bony attachment at the latest follow-up. When patients undergoing minimally invasive UKA were matched for demographics to patients electing to undergo TKA, the UKA cohort reported significantly better PROMs than the TKA group, 22 whereas others have reported a superior Forgotten Joint Score in a similar comparison.…”

Section: Discussionsupporting

confidence: 53%

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Scholes¹,

Ebrahimi²,

Field

et al. 2019

J Knee Surg

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There are limited medium-term outcome data available for the Repicci II device in unicompartmental knee arthroplasty (UKA). The purpose of this study was to report the medium-term (minimum 2 years) patient-reported outcomes and long-term (up to 14 years) procedure survival in a consecutive series of patients undergoing an inlay prosthesis UKA (Repicci II) at an independent orthopaedic clinic. Patients presenting with medially localized unicompartmental knee osteoarthritis and meeting the criteria appropriate for UKA were recruited to a clinical patient registry at the time of presentation. A cemented unicompartmental prosthesis (Repicci II) was implanted using minimally invasive techniques with rapid postoperative mobilization. Patients were asked to complete patient-reported outcomes preoperatively and annually postoperatively. A procedure list was cross-matched with the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), and an analysis of procedure survival was performed with comparison to the national data for UKA. Data from a cohort of 661 primary medial compartment UKA procedures performed in 551 patients over a 15-year period were extracted from the clinical patient registry. Significant improvements were maintained in general health, disease symptoms, pain, and function at an average follow-up of 9 years compared with preoperative data. Threshold analysis revealed that >65% of patients exceeded Patient Acceptable Symptom State at the latest follow-up, with >80% within or exceeding age-matched norms for general health. Cumulative revision rate was significantly lower than that reported for UKA in the AOANJRR at up to 13 years follow-up. This series represents a lower cumulative revision rate than previously reported, with >65% of patients reporting satisfactory functional outcomes at an average of 9 years from surgery. Surgical options for treating unicompartmental knee osteoarthritis could include UKA as a viable alternative; however, clear definitions of procedure success and its overall cost–benefit ratio in the context of ongoing management of knee osteoarthritis remain to be elucidated.

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Section: Discussionsupporting

confidence: 53%

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Scholes¹,

Ebrahimi²,

Field

et al. 2019

J Knee Surg

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“…One of the most controversial topics in the literature is whether to implement fixed or mobile prosthesis on the patients for whom we adopt to implement unicondylar knee prosthesis and successful results have been obtained in both fixed and mobile unicondylar prosthesis (19)(20)(21). While there was no significant difference in fixed and mobile prosthesis knee scores, the range of motion in a mobile prosthesis is much higher compared to a fixed prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Which Unicondylar Prosthesis Has Better Mid-Term Results: Fixed or Mobile?

Bülbül¹,

Kuyucu²,

Kara³

et al. 2016

JAREM

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Objective: Osteoarthritis, which is one of the most common causes of pain and motion loss, is an important medical disease that particularly affects elderly people. Unicondylar knee arthroplasty treatment is still a challenge for obese and/or ACL deficient patients. In addition, surgeons have difficulty in decision making whether to use fixed or mobile bearing designed unicompartmental knee prosthesis. The objective of this study was to evaluate the effect of fixed or mobile insert design prosthesis on the mid-term results of patients that were followed up for 8 years or more.Methods: Between 2003 and 2014, 293 patients were treated with unicondylar knee arthroplasty due to medial gonarthrosis, and 239 patients that we followed up for at least 18 months were included in the study. Nine of the patients (3.7%) underwent bilateral operation, 193 (77.8%) patients were operated with the fixed insert design, and 55 (22.2%) patients were operated with the mobile insert design. A total of 248 knees were evaluated retrospectively. 64±5.32 (68-78), and the mean Knee Society Knee Scoring System (KSS) score was 70.6±3.9 (66-89). The postoperative mean WOMAC value was 97.23±4.02 (92-100) (p<0.05), and the mean KSS score was 92.3±3.94 (85-100) (p<0.05). Results Conclusion:When we compared the fixed and mobile insert design prosthesis, there was no statistically significant difference between the knee scores, but the mobile insert design prosthesis had better flexion degrees. We have observed 97.2% prosthesis survival rates over 8 years. In conclusion, unicondylar knee prosthesis is a good treatment option, with a high success rate for medial knee osteoarthritis. (JAREM 2016; 6: 31-4)

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“…However, studies reporting the causes and chronology of these failures, along with the implants needed during the revision surgery, are rare in the literature. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

“…Recently published studies, with medium and long-term follow-up, which evaluated unicompartmental arthroplasty using modern implants in properly selected patients, have confirmed these good and excellent results and have demonstrated durability comparable to that of TKA. 9 , 10 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Revision of unicompartmental knee arthroplasty: implants used and causes of failure

Mozella

Gonçalves

Vasconcelos

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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Objectiveto determine the causes of unicondylar knee arthroplasty failures, as well as identify the implants used and the need of bone grafting in patients undergoing revision UKA in Center of Knee Surgery at the Instituto Nacional de Traumatologia e Ortopedia (INTO) in the period between January 1990 and January 2013.Methodsa retrospective analysis of the medical documentation and imaging, determining the cause of failure of UKA and the time of its occurrence, as well as prosthetic components implanted during the review and the need for bone grafting.Resultsin this study, 27 UKA failures in 26 patients were included. Collapse of one or more components was the main cause of failure, occurring in 33% of patients. Aseptic failure was identified in 30% of cases, progression of osteoarthrosis in 15%, infection and pain 7% each, and osteolysis and polyethylene failure in 4% each. Early failure occurred in 41% of all revisions of UKA and late failure in 59%. 23 patients have undergone revision of UK.Conclusionin 35% of revisions the use of bone grafting was needed in tibial area; in 3 cases we needed allograft from Tissue Bank. We did not use metal increase in any of the revision. In one patient we used implant constraint for instability.

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Results of Unicompartmental Knee Arthroplasty With Cemented, Fixed-Bearing Prosthesis Using Minimally Invasive Surgery

Cited by 32 publications

References 32 publications

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Minimally Invasive Inlay Prosthesis Unicompartmental Knee Arthroplasty for the Treatment of Unicompartmental Osteoarthritis: A Prospective Observational Cohort Study with Minimum 2-Year Outcomes and up to 14-Year Survival

Which Unicondylar Prosthesis Has Better Mid-Term Results: Fixed or Mobile?

Revision of unicompartmental knee arthroplasty: implants used and causes of failure

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