Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty — results of a multicentre study

Saldanha, K.A.N.; Keys, Graham W.; Svärd, U. C. G.; White, Stephen H.; Rao, Chandra

doi:10.1016/j.knee.2007.03.005

Cited by 110 publications

(83 citation statements)

References 17 publications

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“…More recently, rev-UKA has been described as less technically demanding than rev-TKA [4,6,14,16,18,23,24], perhaps as a result of improvements in prosthetic design [16,23]. The results of our study provide additional evidence that rev-TKA is technically more complex than rev-UKA, using the proxy of need for metal augmentation and stems and operative time.…”

Section: Discussionmentioning

confidence: 59%

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Registry Outcomes of Unicompartmental Knee Arthroplasty Revisions

Dudley

Gioe

Sinner

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Perceptions of the difficulty and outcome of unicompartmental knee arthroplasty revision (rev-UKA) vary. We analyzed differences in the complexity, cost, and survival of rev-UKAs compared with revision TKAs (rev-TKA). One hundred eighty knee arthroplasty revisions (68 rev-UKAs/112 rev-TKAs), defined as a minimum of tibial or femoral component revision, were identified from a community joint registry of 7587 knee implants performed between 1991 and 2005. Four of 68 rev-UKAs (5.9%) were revised a second time, whereas seven of 112 rev-TKAs (6.3%) were rerevised. Rev-TKA was predictably more complex than rev-UKA based on the proxies of operative time, use of modular augmentation and stems, and polyethylene liner thickness. Thirty-nine of 68 rev-UKAs (57%) had no form of augmentation and were revised as primary TKAs. There were more rev-TKAs than rev-UKAs with an implant cost greater than $5200 (42% versus 12%) and hospital charges greater than $33,000 (48% versus 25%). We found no difference in survival between the groups. Although rev-UKAs had less surgical complexity and bone loss at the time of revision compared with rev-TKAs, we were unable to show improved survival of rev-UKAs compared with rev-TKAs. Rev-UKAs were associated with lower implant costs and hospital charges compared with rev-TKAs.

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Section: Discussionmentioning

confidence: 59%

“…More recent reports concerning contemporary rev-UKA have been more favorable, noting a technically straightforward approach in terms of revision joint replacement surgery [4,6,14,16,18,23,24].…”

Section: Introductionmentioning

confidence: 99%

Registry Outcomes of Unicompartmental Knee Arthroplasty Revisions

Dudley

Gioe

Sinner

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Proposed advantages of UKA over TKA include both technical factors (less invasive surgery, preservation of bone stock, comparative ease of revision) [5,32,37,41,56] and improved clinical outcomes (superior knee kinematics, less blood loss, faster recovery, shorter inpatient stay) [4, 20-22, 25-27, 50, 62]. Clinical outcome scores have previously focused on absolute values at preoperative and postoperative review.…”

Section: Discussionmentioning

confidence: 99%

“…TKA, including minimal access surgery, preservation of bone stock, and ease of revision [5,32,37,41,56], as well as superior knee ROM and kinematics, less blood loss, faster recovery, and a decreased hospital admission [4, 20-22, 25-27, 50, 62]. Satisfaction after either TKA or UKA is similar [54].…”

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

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137

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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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“…26 Others reported that revision of UKA to TKA was equivalent to performing a primary TKA, although the use of tibial augmentation was higher with this bearing design. 27,28 Limited studies on revision of a failed UKA to a new UKA are available. In a French multicenter series of 425 revised UKAs, 36 had UKA-to-UKA revision with 88.9% implant survival and International Knee Society scores exceeding 90/100 at a mean follow-up of 8.3 years.…”

Section: Revision Surgerymentioning

confidence: 99%