The Repicci II® Unicondylar Knee Arthroplasty: 9-year Survivorship and Function

Abstract

Background Unicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. UKA using minimally invasive surgery (MIS) has the theoretical advantage of less bone resection and quicker rehabilitation. Whether the function of patients with UKA compares with that of patients with conventional TKA is unclear. Questions/purposes We determined (1) the length of stay and complications associated with a short-stay MIS protocol; (2) whether MIS techniques allow for accurate positioning of the implant and alignment of the limb; (3) the change in functional scores; (4) the revision rate, reasons for revision, and survival of this implant. Patients and Methods We prospectively followed 100 patients who had 114 UKAs. All completed an International Knee Society (IKS) score preoperatively, at 1 year, and at last followup. We determined survivorship. Minimum followup was 5.2 years (mean, 7.4 years; range, 5.2-9 years). Results Mean length of stay was 1.2 days, with 41% discharged the same day. The perioperative complication rate was 6%. The mean IKS score improved from 77 to 93 and was 86 at last followup. The mean hip-knee-ankle axis changed from 6°varus to 1.7°varus. Twenty-two patients underwent a revision procedure at a mean 6.2 years after the index procedure. Survivorship of the prosthesis was 78% at 9 years. Conclusions The short-stay protocol was not associated with a high perioperative complication rate. This technique is associated with improvement in function and restoration of limb alignment, allowing accurate positioning of the implant. Compared with other reports of survival of UKA, this implant had a lower survivorship and increased revision rate.

Good results with minimally invasive unicompartmental knee resurfacing after 10-year follow-up

“…In contrast, O’Donnell et al prospectively followed 100 patients who underwent 114 UKAs with the study system under a short-stay MIS protocol. With 22 patients revised a mean of 6.2 years later, the 9-year survival of the prosthesis was estimated at 78% [18]. …”

“…The popularity of the Repicci prosthesis has waned recently due to variable survivorship outcomes, the need for a freehand bone sculpting, and fears over subsidence of the tibial inlay. While good short- and mid-term functional results have been reported [17, 18], and a study by the device inventor reported low revision rates after 8 years [19], one investigation [18] reported lower mid-term survivorship and rates of revision than those recorded for other UKA systems [20–22]. However, the longevity of UKA is highly dependent on the surgical technique, as well as on implant position and alignment [23, 24].…”

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration

“…(Intra-observer variability, FTA = 0.87, TPA = 0.83, PTS = 0.80). Moreover, since limb alignment and survivorship in a UKA are very sensitive to change in JL [39][40][41]; a previously validated method, based on the correlation between femoral width and the distance from the femoral adductor tubercle to JL, was used for radiographic JL measurement [42]. Briefly, the JL was assessed by calculating the distance from the adductor tubercle according to the femoral width multiplied by a validated ratio [43].…”

Results of a French multicentre retrospective experience with four hundred and eighteen failed unicondylar knee arthroplasties

“…Based on current survival rates at ten years follow-up, survival ranges from 53 to 95 % [1][2][3][4][5][6][7][8][9][10][11]. The term "failure" can be defined in a number of ways.…”