Analysis of revision procedures for failed unicondylar knee replacement

Oduwole, K. O.; Sayana, Murali Krishna; Onayemi, F.; McCarthy, Tom; O’Byrne, J.

doi:10.1007/s11845-009-0454-x

Cited by 24 publications

(19 citation statements)

References 17 publications

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“…8 (vs. 19.8 in the primary TKA group) in their study of 63 UKA revisions after 3.1 years mean follow-up. It is also significantly better than Oduwole et al [22], who found a mean WOMAC score of 33.3 in their series.…”

Section: Discussionmentioning

confidence: 49%

Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

Ironside

Coffey²,

Eslick³

et al. 2015

JISRF

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Introduction: Unicompartmental knee arthroplasty (UKA) can be used to treat medial compartment osteoarthritis of the knee. Some of these knees will eventually fail, and need to be revised. There is controversy about using UKA in younger patients as a definitive procedure or as a means to delay total knee arthroplasty (TKA) because the outcomes of subsequent revision surgery may be inferior to a primary TKA.Methods: We retrospectively reviewed a series of 46 revision TKA patients following failed UKA (UKA revisions) using functional outcomes questionnaires and compared the results with a cohort of age and gender matched primary TKA patients. Our hypothesis was that UKA revision surgery would be inferior to primary TKA surgery.Results: Data was collected on 33 knees after a mean follow-up period of five years. There was no significant difference in the Oxford Knee Score (33.7 vs 37.1, p = 0.09) or the Western Ontario and MacMasters Universities Arthritis Index (WOMAC) (24.8 vs. 19.1, p = 0.22). A subgroup analysis demonstrated that UKAs, which fail early, are more likely to produce an inferior outcome following revision surgery than those that survive more than five years.Discussion: We conclude that UKA can be used effectively in appropriately selected patients, as the functional outcome of their subsequent revision to TKA is not significantly inferior to a primary TKA.

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Section: Discussionmentioning

confidence: 49%

Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

Ironside

Coffey²,

Eslick³

et al. 2015

JISRF

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confidence: 99%

“…Revision rates of 6–13% have been reported (Vardi and Strover 2004, Oduwole et al 2009). Oduwole et al (2009) reported that due to possible bone loss, the potential need for augmentations, and use of long-stem prostheses, insertion of a new total knee arthroplasty (TKA) in the proper position can be technically demanding. However, others have found it to be straightforward and less technically demanding than revision TKA (McAuley et al 2001, Dudley et al 2008, Oduwole et al 2009).…”

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confidence: 99%

“…Oduwole et al (2009) reported that due to possible bone loss, the potential need for augmentations, and use of long-stem prostheses, insertion of a new total knee arthroplasty (TKA) in the proper position can be technically demanding. However, others have found it to be straightforward and less technically demanding than revision TKA (McAuley et al 2001, Dudley et al 2008, Oduwole et al 2009). Both Dudley et al (2008) and Oduwole et al (2009) reported that in 43% of UKA-to-TKA revision surgery, a long femoral or tibial stem, metal augments, or bone grafting was needed.…”

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confidence: 99%

“…However, others have found it to be straightforward and less technically demanding than revision TKA (McAuley et al 2001, Dudley et al 2008, Oduwole et al 2009). Both Dudley et al (2008) and Oduwole et al (2009) reported that in 43% of UKA-to-TKA revision surgery, a long femoral or tibial stem, metal augments, or bone grafting was needed. Proper preoperative planning can make revision less difficult (Saragaglia et al 2009), and computer-assisted surgery peroperatively may be of value (Confalonieri et al 2010).…”

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confidence: 99%

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Patient-specific guide for revision of medial unicondylar knee arthroplasty to total knee arthroplasty

Kerens¹,

Boonen²,

Schotanus³

et al. 2013

Acta Orthopaedica

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Background and purpose Unicompartmental to total knee arthroplasty revision surgery can be technically demanding. Joint line restoration, rotation, and augmentations can cause difficulties. We describe a new technique in which single-way fitting guides serve to position the knee system cutting blocks.Method Preoperatively, images of the distal femur and proximal tibia are taken using CT scanning. These images are used to create a patient-specific guide that fits in one single position on the contours of the bone and the prosthesis in situ. The guides are fixed with pins and then removed. The pins determine the position of the cutting blocks. 10 consecutive revisions were performed using this technique.Results All guides fitted well. 7 of 10 femoral prostheses were within the desired AP and sagittal angle ± 3°. However, 1 proximal tibia did not have enough bone stock on the medial plateau for adequate fixation of the guide, so conversion to intramedular referencing was performed. This was to be expected after the preoperative planning. All tibial components were within the desired AP angle ± 3° and 7 of 10 were within the desired sagittal angle. Hip-knee-ankle angle was within 0 ± 3° in 8 of 10 cases.Interpretation This new technique makes preoperative planning and execution of this plan during surgery less demanding. Problems such as the need for augmentations can be predicted at the preoperative planning. The instrumentation must be redesigned in order to make this technique work in cases where there is minimal bone stock present.

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Joint Resurfacing of the Shoulder and Knee in Athletes

Athiviraham¹,

Kodali²,

Miniaci³

2015

Sports Injuries

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Analysis of revision procedures for failed unicondylar knee replacement

Abstract: Results of conversion of UKA to TKA are less satisfactory than primary TKA.

Cited by 24 publications

References 17 publications

Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

Patient-specific guide for revision of medial unicondylar knee arthroplasty to total knee arthroplasty

Joint Resurfacing of the Shoulder and Knee in Athletes

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