Update on unicompartmental knee arthroplasty

Vasso, Michele; Antoniadis, Alexander; Helmy, Naeder

doi:10.1302/2058-5241.3.170060

Cited by 60 publications

(20 citation statements)

References 63 publications

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“…15,16 This procedure could be associated with problems such as poly wear, progression of arthritis, or loosening of components. 17,18 Certain studies have demonstrated a high rate of revision for unicondylar knee replacement as compared to a total knee replacement. 19 In this scenario, there is a need for a procedure that is simple to perform, easily reproducible, gives good functional results, and is associated with a shorter recovery period thereby improving the quality of life of the affected patients.…”

Section: Discussionmentioning

confidence: 99%

How does medial compartment osteoarthritis of knees respond to proximal fibular osteotomy at one year ? – A prospective analysis of 26 knees

Ss¹,

Manivannan²,

Jeyaraman³

2021

IJOR

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Introduction: Knee osteoarthritis (OA) is a chronic, progressive degenerative disease with joint pain, stiffness, and deformity. Knee OA is a common joint disease, with an incidence of 30% of the population older than 60 years. High tibial osteotomy and total knee arthroplasty are the 2 commonly used methods for treating knee OA. Total knee Arthroplasty (TKA), which aims to relieve pain and improve joint function and mobility, primal fibular osteotomy (PFO) is the main surgical alternative in this patient population. Materials and Methods: From September 2017 to September 2019, the PFO was performed for patients presenting with medial compartment osteoarthritis. Preoperative and postoperative weight-bearing whole lower extremity radiographs were obtained to analyze the alignment of the lower extremity and the ratio of the knee joint spaces (medial/lateral compartment) were ascertained. Knee pain was assessed using a visual analog scale (VAS), and knee ambulation activities were evaluated using the Knee Society Score (KSS).Results: A total of 20 patients and 26 knees were followed-up for a minimum period of one year. Of these, 7 were male and 13 were female patient. The average age was 57 years. According to Kellgren Lawrence grading, there were 18 knees of grade 2 and 2 knees of grade 3. The average preoperational VAS score and KSS were 6.3 and 33.5 respectively. The average postoperative VAS score and KSS improved significantly to 2.8 (P<0.01) and 83.7 (p=0.002) respectively. The medial joint space opening has improved significantly from preoperatively 1.15mm to postoperatively 3.4mm. Conclusion : PFO is a promising alternative procedure in the management of medial compartment osteoarthritis of the knee being a simple and cost-effective alternative to the traditional total knee or unicondylar knee replacements. A longer period of follow-up is necessary to evaluate whether the beneficial effects of PFO are sustained over a period of time. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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Section: Discussionmentioning

confidence: 99%

How does medial compartment osteoarthritis of knees respond to proximal fibular osteotomy at one year ? – A prospective analysis of 26 knees

Ss¹,

Manivannan²,

Jeyaraman³

2021

IJOR

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“…Шкала WOMAC является реверсивным опросником; результаты, полученные с использованием этой шкалы, также подтверждают улучшение ранних функциональных результатов. Стоит отметить, что в работах других ученых представлены данные о том, что большинство осложнений после ОЭКС происходят в первые 5 лет, что связывают с ошибками в определении показаний для данной тактики хирургического лечения, а также с относительно небольшим числом выполняемых операций ОЭКС по сравнению с числом ТЭКС и недостаточно отработанной хирургической техникой при выполнении данных операций [21,22].…”

Section: пациентыunclassified

Unicompartmental Knee Arthroplasty: Short-Term Results

Мурылев¹,

Ерохин²,

Елизаров³

et al. 2021

Traumatology and Orthopedics of Russia

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Background. Among the methods of surgical treatment of early stages medial knee osteoarthritis in the partial knee replacement (PKR) becomes more and more relevant. The relevance and increasing number of PKR are confirmed by data from various national registers.The aim of the study was to research the early functional results of PKR and to analyze the complications at various stages of the postoperative period.Material and Methods. Study design: a single-center prospective study. The results of 90 operations of PKR in the period from March 2018 to April 2020 are presented. Assessment of knee function and quality of life of patients was performed according to three scalesquestionnaires: KOOS, WOMAC, SF-36, which were filled in preoperatively and then at 3, 6, 9, 12, 18 months. after surgery. Patients within the reporting period provided X-rays and filled in the scales at the face-to-face examination and at remote contact.Results. The most significant improvement of quality of life and median values of the functional results observed after 3 months, and after 18 months. After replacement the best median functional outcome scales KOOS, WOMAC, SF-36 — 79,4 (73,6–84,3); 27,1 (24,8–30,6); 89,1 (85,3–92,6) compared with the functional results obtained before surgery 32,3 (22,8–38,4); 73,6 (63,6–78,8); 35,2 (31,3–42,1); p = 0,027; p = 0.023; p = 0,028, respectively. A negative correlation was obtained between BMI and functional outcome (p = 0.027, R = -0.7).Conclusion. PKR allowed us to achieve an improvement in the quality of life and functional results already in the early postoperative period (from 3 to 18 months after the operation). The improvement of the operating technique, the analysis of errors and the regularity of the performed PKR will improve the results of PKR and minimize the number of complications.

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“… 2 - 4 Errors in alignment of the UKA implants, poor patient selection, and low-volume centres have been proposed as risk factors for reduced long-term survival. 5 In a large, randomized controlled trial (RCT), Beard et al 6 demonstrated a substantially lower number of revisions, high satisfaction, and improved cost-effectiveness of manual UKAs compared to TKAs, “when performed by those with adequate experience”.…”

Section: Introductionmentioning

confidence: 99%

Robotic arm-assisted versus conventional medial unicompartmental knee arthroplasty: five-year clinical outcomes of a randomized controlled trial

Banger

Doonan

Rowe

et al. 2021

The Bone & Joint Journal

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Aims Unicompartmental knee arthroplasty (UKA) is a bone-preserving treatment option for osteoarthritis localized to a single compartment in the knee. The success of the procedure is sensitive to patient selection and alignment errors. Robotic arm-assisted UKA provides technological assistance to intraoperative bony resection accuracy, which is thought to improve ligament balancing. This paper presents the five-year outcomes of a comparison between manual and robotically assisted UKAs. Methods The trial design was a prospective, randomized, parallel, single-centre study comparing surgical alignment in patients undergoing UKA for the treatment of medial compartment osteoarthritis (ISRCTN77119437). Participants underwent surgery using either robotic arm-assisted surgery or conventional manual instrumentation. The primary outcome measure (surgical accuracy) has previously been reported, and, along with secondary outcomes, were collected at one-, two-, and five-year timepoints. Analysis of five-year results and longitudinal analysis for all timepoints was performed to compare the two groups. Results Overall, 104 (80%) patients of the original 130 who received surgery were available at five years (55 robotic, 49 manual). Both procedures reported successful results over all outcomes. At five years, there were no statistical differences between the groups in any of the patient reported or clinical outcomes. There was a lower reintervention rate in the robotic arm-assisted group with 0% requiring further surgery compared with six (9%) of the manual group requiring additional surgical intervention (p < 0.001). Conclusion This study has shown excellent clinical outcomes in both groups with no statistical or clinical differences in the patient-reported outcome measures. The notable difference was the lower reintervention rate at five years for roboticarm-assisted UKA when compared with a manual approach. Cite this article: Bone Joint J 2021;103-B(6):1088–1095.

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Update on unicompartmental knee arthroplasty

Cited by 60 publications

References 63 publications

How does medial compartment osteoarthritis of knees respond to proximal fibular osteotomy at one year ? – A prospective analysis of 26 knees

How does medial compartment osteoarthritis of knees respond to proximal fibular osteotomy at one year ? – A prospective analysis of 26 knees

Unicompartmental Knee Arthroplasty: Short-Term Results

Robotic arm-assisted versus conventional medial unicompartmental knee arthroplasty: five-year clinical outcomes of a randomized controlled trial

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