Ten year survivorship after cemented and uncemented medial Uniglide® unicompartmental knee arthroplasties

Schlueter-Brust, Klaus; Kugland, Karoline; Stein, Gregor; Henckel, Johann; Christ, Hildegard; Eysel, Peer; Bontemps, G.

doi:10.1016/j.knee.2014.03.009

Cited by 39 publications

(27 citation statements)

References 57 publications

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“…Based on previous studies that showed a UKA survivorship of 85% to 95% [17][18][19][20][21] , we conservatively assumed that the prevalence of revision would be 20% in our population. In sample size calculations for prevalence studies, an assumed prevalence closer to 50% is more conservative 29 .…”

Section: Sample Size Calculationmentioning

confidence: 99%

Unicompartmental Knee Arthroplasty: Survivorship and Risk Factors for Revision

Ekhtiari

Bozzo

Madden

et al. 2021

Journal of Bone and Joint Surgery

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Background:Operative management for end-stage knee osteoarthritis (OA) primarily consists of arthroplasty. Total knee arthroplasty (TKA) is the so-called gold standard for multicompartmental OA. In selected patients, specifically those with unicompartmental OA and no definite contraindications, realignment osteotomies and unicompartmental knee arthroplasty (UKA) are viable options. UKA offers several advantages over TKA, including preservation of both cruciate ligaments, faster recovery, and less osseous resection. The purpose of this study was to determine the survivorship of UKAs and risk factors for all-cause revision surgery in patients with a minimum follow-up of 10 years in a large population-based database.Methods:We performed a population-based cohort study using linked administrative databases in Ontario, Canada. We identified all UKAs performed from January 2002 through December 2006. All patients had a minimum 10-year follow-up. Demographic data and outcomes were summarized using descriptive statistics. We used a Cox proportional hazards model with the Fine and Gray method accounting for competing risks such as death to analyze the effect of surgical and patient factors on the risk of revision of UKA.Results:A total of 4,385 patients were identified as having undergone primary UKA from 2002 through 2006 in Ontario. Of these patients, 779 underwent revision surgery, for a cumulative risk for all-cause revision of 16.5% at 10 years (95% confidence interval [CI]: 15.4% to 17.7%). Mechanical loosening was the reason for 83.4% of all revisions. Male sex, diabetes, an age younger than 50 years, and cementless implants were significant risk factors for revision surgery. Residence in a rural or urban setting, income quintile, discharge destination, and type of OA were not associated with the risk of revision. Survivorship at 1, 5, 10, and 15 years was 97.2%, 90.5%, 83.5%, and 81.9%, respectively.Conclusions:This study demonstrated a >80% long-term survivorship for UKA based on a large administrative database sample and identified important risk factors for failure including male sex, younger age, diabetes, and cementless fixation. This study found rates of survivorship similar to those previously reported in the literature, while identifying key risk factors for failure. Patient selection has always been identified as a key factor in ensuring successful UKA, and the risk factors identified in this study may help guide decision-making for surgeons and patients dealing with unicompartmental knee OA.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Section: Sample Size Calculationmentioning

confidence: 99%

Unicompartmental Knee Arthroplasty: Survivorship and Risk Factors for Revision

Ekhtiari

Bozzo

Madden

et al. 2021

Journal of Bone and Joint Surgery

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“…From 1998 to 2005, the utilization of UKA increased almost three times faster than total knee replacement due to less blood loss, higher range of motion after operation, preservation of bone mass and ligaments, and faster recovery. A large number of researchers have shown that the survivorship rate of modern UKA prosthesis is greater than 90% and the rate of postoperative complications is relatively low over 10‐years follow‐up. Currently, the assessment methods for the postoperative outcomes of joint replacement often focus on objective clinical evaluations such as postoperative activity, survival of prosthesis, complication and revision rate, which often ignore the subjective feelings of patients themselves, and may cause differences in postoperative focus between patients and surgeons.…”

Section: Introductionmentioning

confidence: 99%

Joint Awareness after Unicompartmental Knee Arthroplasty Evaluated with the Forgotten Joint Score

Dai

Lin

Yang

et al. 2020

Orthopaedic Surgery

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Objective: To investigate the temporal relationship of medial unicompartmental knee arthroplasty (UKA) and forgotten joint score (FJS), and to analysis the predictive factors associated with FJS after medial UKA.Methods: This is a cross-sectional observational study. A total of 188 cases of medial UKA were included in this study, and all the prostheses used were Oxford mobile-bearing UKA from January 2016 to January 2019. All patients have completed the questionnaire of FJS, and the relevant data were obtained for 1 month (n = 38), 6 month (n = 40), 12 month (n = 42), 24 month (n = 34), and 36 month (n = 34) patient subgroups. The score ranged from 0-100, with a higher score indicating a more natural knee joint. In addition, the associations between the potential influencing factors (body mass index [BMI], age, gender, duration of onset before surgery, Kellgren-Lawrence grade of the medial compartment before surgery) with FJS were analyzed using Pearson correlation and multiple linear regression.Results: Postoperative FJSs were 44.5 AE 13.5 at 1 month，63.8 AE 10.1 at 6 months, 77.1 AE 12.2 at 12 months, 78.4 AE 12.2 at 24 months, 78.9 AE 12.5 at 36 months. The postoperative FJSs were lowest at 1 month and highest at 36 month (P < 0.01). The mean value of FJS kept improving until 12 months post-operation, which was slightly lower than that of 24 months and 36 months, but there was no statistical difference between them. Pearson correlation and multiple linear regression analysis showed that gender and Kellgren-Lawrence grade of the medial compartment before surgery had no significant influence on FJS, while age, BMI, and duration of onset before surgery had significant associations with FJS after UKA. BMI was negatively correlated with FJS, while older patients (>60) and with longer duration of onset before surgery (>3 years) were a positive predictor of good outcome for the FJS.Conclusion: Patients can expect marked improvement in the natural feel of the prosthesis during the first year after UKA, slight continued improvement at 2 and 3 years. Furthermore, we identified three preoperative patient-related factors (age, BMI, and duration of onset before surgery) that may predict the FJS after medial UKA, which can be used to guide surgical decision making.

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“…2 3 Several reports have already demonstrated survival rates greater than 90% at 10 years after modern UKA implantation. 1 4 5 6 7 Despite this, results of knee replacement registries still show a relatively high revision and failure rate for UKA, especially when compared with traditional TKA. 8 Failures of UKAs have distinctive characteristics, and consensus on the causes and the proper treatment methods has been elusive.…”

Section: Introductionmentioning

confidence: 99%

Unicompartmental Knee Arthroplasty: Modes of Failure and Conversion to Total Knee Arthroplasty

Vasso

Corona

D’Apolito

et al. 2017

Joints

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Despite the excellent success rates of the modern unicompartmental knee arthroplasty (UKA), results of knee replacement registries still shows a relatively high revision and failure rate for UKA, especially when compared with traditional total knee arthroplasty (TKA). Bearing dislocation continues to be advocated as the predominant mechanism of failure in mobile UKA, whereas polyethylene wear and aseptic loosening remains the main cause of failure of fixed UKA. Degeneration of the unreplaced compartments has been reported in both mobile and fixed designs. When the revision is required, most of failed UKAs are converted to TKAs. Surgical challenges of the UKA revision, and outcomes of UKA converted to TKA are still debated in literature.

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Ten year survivorship after cemented and uncemented medial Uniglide® unicompartmental knee arthroplasties

Cited by 39 publications

References 57 publications

Unicompartmental Knee Arthroplasty: Survivorship and Risk Factors for Revision

Unicompartmental Knee Arthroplasty: Survivorship and Risk Factors for Revision

Joint Awareness after Unicompartmental Knee Arthroplasty Evaluated with the Forgotten Joint Score

Unicompartmental Knee Arthroplasty: Modes of Failure and Conversion to Total Knee Arthroplasty

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