Role of magnetic resonance imaging in the diagnosis of the painful unicompartmental knee arthroplasty

Park, Caroline N.; Zuiderbaan, Hendrik A.; Chang, Anthony; Khamaisy, Saker; Pearle, Andrew D.; Ranawat, Anil S.

doi:10.1016/j.knee.2015.03.007

Cited by 18 publications

(23 citation statements)

References 45 publications

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“…We apply and propose an oblique minimal invasive skin incision avoiding the course of the infrapatellar branch of the saphenous nerve for this procedure. In some cases MRI can be helpful in exploring the source of pain [43]. Indicating the operation with full thickness cartilage loss has been shown to reduce revision rate [44,45].…”

Section: Discussionmentioning

confidence: 99%

Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years

Forster-Horváth

Artz²,

Hassaballa

et al. 2016

The Knee

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Section: Discussionmentioning

confidence: 99%

Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years

Forster-Horváth

Artz²,

Hassaballa

et al. 2016

The Knee

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“…The methodological quality of the accuracy studies assessed with QUADAS‐2 varied from a high risk of bias to a low risk of bias . Criterion validity was assessed by comparing MRI findings with perioperative findings . Construct validity was determined by using different standards as comparators, such as CT, knee pain, and healthy controls .…”

Section: Resultsmentioning

confidence: 99%

“…19,25,29,30,34 Criterion validity was assessed by comparing MRI findings with perioperative findings. 10,19,25,29,[31][32][33][35][36][37] Construct validity was determined by using different standards as comparators, such as CT, 30,34 knee pain, 38 and healthy controls. 26 Due to the retrospective designs of the included studies, which is thought to increase susceptibility to selection bias, none of the retrospective studies scored "low risk" for the patient selection bias by QUADAS-2.…”

Section: Accuracymentioning

confidence: 99%

MRI as Diagnostic Modality for Analyzing the Problematic Knee Arthroplasty: A Systematic Review

Schröder

Post

Wagenaar

et al. 2019

Magnetic Resonance Imaging

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Background Various diagnostic modalities are available to assess the problematic knee arthroplasty. Visualization of soft‐tissue structures in relation to the arthroplasty and bone remains difficult. Recent developments in MRI sequences could make MRI a viable addition to the diagnostic arsenal. Purpose To review the diagnostic properties of MRI, to identify certain causes of complaints that may be directly related to implant failure of total (TKA) or unicompartmental knee arthroplasty (UKA); infection, loosening and wear, instability, malalignment, arthrofibrosis, or patellofemoral problems. Study Type Systematic review. Population Twenty‐three studies were included: 16 TKA, four UKA, and three cadaveric studies. Causes of knee arthroplasty complaints analyzed were; infection (three), loosening and wear (11), malalignment (five) and instability (four). Field Strength and Sequences No field strength or sequence restrictions. Assessment PubMed, SCOPUS, and EMBASE were searched. Risk of bias was assessed using the COnsensus‐based Standards for the selection of health Measurement Instruments (COSMIN) and the QUality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2). Statistical Tests The results of the original research articles are stated. Results Fifteen studies assessed the reproducibility of analyzing infection, loosening and wear, and malalignment. Fourteen of 15 studies were deemed as adequate to good quality. Results showed a moderate to excellent agreement (ICC/K 0.55–0.97). Fourteen studies addressed the accuracy. For infection and loosening and wear the sensitivity and specificity estimates varied between 0.85–0.97 and 0.70–1.00, respectively. The accuracy for malalignment was excellent (r ≥ 0.81). For these studies QUADAS‐2 analysis suggested few risks of bias. A meta‐analysis was not possible due to the heterogeneity of the data. Data Conclusion This study supports that MRI can be used with overall reproducible and accurate results for diagnosing infection, loosening and wear, and malalignment after knee arthroplasty. Nonetheless, studies regarding the diagnosis of instability, arthrofibrosis or patellofemoral complaints using MRI are limited and inconclusive. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:446–458.

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“…Among 4–23% of the patients with UKA experience pain postoperatively without any obvious reason after the traditional examinations 32 43 92. Park et al 93 recently performed a diagnostic MRI-based study, in order to create a greater insight into the aetiology of the symptomatic patients where physical and traditional radiographs were not aberrant. MRI examination was found to be instrumental in diagnosing these patients.…”

Section: Current State Of the Artmentioning

confidence: 99%

“…MRI examination was found to be instrumental in diagnosing these patients. The most common pathologies based on MRIs included loose bodies, osteolysis, tibial loosening, synovitis, stress fractures and infection 93. Baker et al 92 compared the proportion of UKA and TKA revisions that were performed because of unexplained pain as recorded in the National Joint Registry of England and Wales 92.…”

Section: Current State Of the Artmentioning

confidence: 99%

Unicompartmental knee arthroplasty: state of the art

et al. 2017

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The popularity of unicompartmental knee arthroplasty (UKA) for the treatment of isolated compartment osteoarthritis of the knee has risen over the past 2 decades. Currently, UKA covers 10% of all knee arthroplasties worldwide. Although indications have been extended, results have proven that patient selection plays a critical role in the success of UKA. From the current perspective, age, body mass index, patellofemoral osteoarthritis, anterior cruciate ligament deficiency and chondrocalcinosis are no longer absolute contraindications for UKA. Motivated by the desire to improve survivorship rates, patient-reported outcomes and reduce complications, there have been many technological advances in the field of UKA over the recent years. The aim of this review was to evaluate the current indications, surgical techniques, modes of failure and survivorship results of UKA, by assessing a thorough review of modern literature. Several studies show that innovations in implant design, fixation methods and surgical techniques have led to good-to-excellent long-term survivorship, functional outcomes and less complications. Until now, resurgence of interest of cementless designs is noted according to large national registries to address problems associated with cementation. The future perspective on the usage of UKA, in particular the cementless design, looks promising. Furthermore, there is a growing interest in robotic-assisted techniques in order to optimise result by controlled soft-tissue balancing and reproduce alignment in UKA. Future advances in robotics, most likely in the field of planning and setup, will be valuable in optimising patient-specific UKA.

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Role of magnetic resonance imaging in the diagnosis of the painful unicompartmental knee arthroplasty

Cited by 18 publications

References 45 publications

Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years

Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years

MRI as Diagnostic Modality for Analyzing the Problematic Knee Arthroplasty: A Systematic Review

Unicompartmental knee arthroplasty: state of the art

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