The Role of Preoperative Patient Characteristics on Outcomes of Unicompartmental Knee Arthroplasty: A Meta-Analysis Critique

List, Jelle P. van der; Chawla, Harshvardhan; Zuiderbaan, Hendrik A.; Pearle, Andrew D.

doi:10.1016/j.arth.2016.04.001

Cited by 83 publications

(52 citation statements)

References 90 publications

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“…They demonstrated that the survival rate of the Oxford UKA does not decrease with increasing BMI, and no statistical differences were found between any of the groups at the 5-year or 10-year follow-up 44. Similar results have been found by other authors and systematic reviews as well 27 42 45 46…”

Section: Current State Of the Artsupporting

confidence: 79%

“…Interestingly, a trend of better functional outcomes is seen in this group 43. This may be explained by the fact that younger patients have high activity levels and high functional demands which are met by UKA, including quicker recovery after surgery and wider ROM 6 7 42…”

Section: Current State Of the Artmentioning

confidence: 84%

“…They demonstrated similar survival rates (97.3%) and functional outcomes at 10-year follow-up compared with patients older than 60 years (95.1%) 27 42. The fear of early polyethylene wear in younger patients, mostly more active patients at that age, is therefore not supported.…”

Section: Current State Of the Artmentioning

confidence: 96%

“…Current literature confirms this by not showing a relationship between preoperative PFOA and inferior outcomes 27 42 48. Beard et al 48 examined 824 consecutive knees, in which 16% had full-thickness cartilage loss at any location in the PF joint.…”

Section: Current State Of the Artmentioning

confidence: 98%

“…By restoring the alignment, the contact forces over the PF joint are lowered 49. Despite the lack of level I evidence, these previously mentioned studies all suggest that PFOA does not influence UKA outcomes 27 42 43 47–50…”

Section: Current State Of the Artmentioning

confidence: 99%

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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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Section: Current State Of the Artsupporting

confidence: 79%

Section: Current State Of the Artmentioning

confidence: 84%

Section: Current State Of the Artmentioning

confidence: 96%

Section: Current State Of the Artmentioning

confidence: 98%

Section: Current State Of the Artmentioning

confidence: 99%

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Unicompartmental knee arthroplasty: state of the art

et al. 2017

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The phenotypic diversity of anteromedial osteoarthritis before and after treatment with medial unicompartmental knee arthroplasty: A radiographic analysis of 1000 knees

Bayoumi,

ten Noever de Brauw,

Ruderman

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThis study aimed to assess phenotypic variation in the coronal plane of knees with anteromedial osteoarthritis using the functional knee phenotype classification, before and after treatment with medial unicompartmental knee arthroplasty (UKA).MethodsThe study comprised 1000 knees of 835 patients (45% females, 55% males, 90% Caucasian) who underwent medial UKA for anteromedial osteoarthritis. Pre and postoperative alignment was evaluated through the hip‐knee‐ankle angle (HKA), femoral mechanical angle (FMA), and tibial mechanical angle (TMA). Knees were classified according to the functional knee phenotype system which combines limb phenotype (HKA), and femoral and tibial knee phenotypes (FMA and TMA, respectively). Restoration of prearthritic coronal alignment following medial UKA was evaluated by phenotype.ResultsPreoperatively, 76 distinct and 25 relevant (prevalence ≥1%) functional knee phenotypes were identified, of which VARHKA6°VARFMA3°NEUTMA0° was the most common (9.4% of knees). The most prevalent limb phenotype, VARHKA6°, comprised 15 distinct knee phenotypes (FMA and TMA combinations). Postoperatively, 58 distinct and 17 relevant functional knee phenotypes were observed, of which VARHKA3°NEUFMA0°NEUTMA0° had the highest prevalence at 18.3%. Knees with combined tibial and femoral deformities were associated with a lower probability of restoration of prearthritic coronal alignment following medial UKA, compared to knees without extra‐articular deformity, or knees with an isolated tibial or femoral deformity.ConclusionPhenotype analysis using the functional knee phenotype system demonstrated a wide diversity of coronal alignment phenotypes among knees with anteromedial osteoarthritis in a predominantly Caucasian population. Following medial UKA, a reduction from 25 preoperative to 17 postoperative relevant phenotypes was observed. Consideration of phenotypic variation can be of importance when aiming to restore prearthritic coronal alignment during medial UKA.Level of EvidenceLevel III, retrospective cohort study.

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Gender does not influence outcomes and complications in medial unicompartmental knee arthroplasty

Royon,

Foissey,

Fontalis

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe impact of gender on the outcomes of unicompartmental knee arthroplasty (UKA) remains a topic of active discussion with limited exploration thus far. The study aims to elucidate the gender effect on clinical outcomes, complications, pre‐ and postoperative radiological outcomes following the implantation of a medial UKA at mid‐term follow‐up in a large section of patients.MethodsThis was a single‐centre, retrospective cohort study encompassing patients undergoing medial UKA between 2011 and 2019. The International Knee Society (IKS) Knee and Function score, patient satisfaction, complications, revisions, pre‐ and postoperative radiological outcomes (coronal plane alignment, femoral and tibial component positioning, posterior tibial slope) were evaluated. Survival rate at the time of the last follow‐up was also recorded.ResultsOf the 366 knees that met the inclusion criteria, 10 were lost to follow‐up, accounting for a 2.7% loss. Mean follow‐up was 5.2 ± 2 years [2.1–11.3]. Out of the total population, 205 patients were females (57.6%, 205/356) and 151 were males (42.4%, 151/356). Men exhibited superior pre‐ and postoperative IKS function scores (p = 0.017). However, no significant differences were observed between women and men regarding improvements of IKS Knee and Function scores, radiographic outcomes and implant survivorship.ConclusionAt a mean follow‐up of 5 years, this study revealed no significant impact of gender on clinical outcomes and complications in patients undergoing medial UKA. Furthermore, no significant differences were evident in radiographic outcomes, implant positioning and knee phenotype.Level of EvidenceLevel III.

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The Role of Preoperative Patient Characteristics on Outcomes of Unicompartmental Knee Arthroplasty: A Meta-Analysis Critique

Cited by 83 publications

References 90 publications

Unicompartmental knee arthroplasty: state of the art

Unicompartmental knee arthroplasty: state of the art

The phenotypic diversity of anteromedial osteoarthritis before and after treatment with medial unicompartmental knee arthroplasty: A radiographic analysis of 1000 knees

Gender does not influence outcomes and complications in medial unicompartmental knee arthroplasty

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