Early Catastrophic Tibial Component Wear After Unicompartmental Knee Arthroplasty

Palmer, Sylvain; Morrison, Peter; Ross, Alistair C.

doi:10.1097/00003086-199805000-00020

Cited by 78 publications

(50 citation statements)

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“…Therefore, subtle improvements, or advantages, of one implant or another would not be perceived due to this ceiling effect. Early survival studies of UKA demonstrated revision rates of 15% to 28% [23,34,44]. More recent articles report substantial increases in survival, with midterm survivorship for UKA of 84% to 98% (Table 1) [10,12,14,19,39,40,42,46,48,[57][58][59][60][61].…”

Section: Discussionmentioning

confidence: 99%

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Lyons

MacDonald

Somerville

et al. 2012

Clinical Orthopaedics &Amp; Related Research

237

140

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Background TKA and unicompartmental knee arthroplasty (UKA) are both utilized to treat unicompartmental knee arthrosis. While some surgeons assume UKA provides better function than TKA, this assumption is based on greater final outcome scores rather than on change in scores and many patients with UKA have higher preoperative scores. Questions/purposes We therefore asked whether TKA would demonstrate (1) better change in clinical outcome scores from preoperative to postoperative states and (2) better survivorship than UKA. Methods We evaluated 4087 patients with 5606 TKAs and 179 patients with 279 UKAs performed between 1978 and 2009. Patients with TKA were older and heavier than patients with UKA (mean age, 68 versus 66 years; mean BMI, 32 versus 29). We compared preoperative, latest postoperative, and change in Knee Society Clinical Rating System (KSCRS), SF-12, and WOMAC scores. Minimum followup was 2 years (UKA: mean, 7 years; range, 2.0-23 years; TKA: mean, 6.5 years; range, 2.0-33 years). Preoperative outcome measure scores (WOMAC, SF-12, KSCRS) were higher in the UKA group. Results Patients with UKA had higher postoperative KSCRS and SF-12 mental scores. Changes in score for all WOMAC domains were similar between groups. Total KSCRS changes in score were similar between groups, although patients with TKA had higher knee scores (49 versus 43) but lower function scores than UKA (21 versus 26). Cumulative revision rate was higher for UKA than for TKA (13% versus 7%). Kaplan-Meier survivorship at 5 and 10 years was 95% and 90%, respectively, for UKA and 98% and 95%, respectively, for TKA. Conclusions While patients with UKA had higher preand postoperative scores than patients with TKA, the changes in scores were similar in both groups and survival appeared higher in patients with TKA.

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Section: Discussionmentioning

confidence: 99%

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Lyons

MacDonald

Somerville

et al. 2012

Clinical Orthopaedics &Amp; Related Research

237

140

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“…The low wear measured for the low conformity Sigma HP PK bearing supports the findings of this recent study, with a low wearing fixed bearing for UKR. Historically, designs of UKR with high contact stresses have been associated with early polyethylene failure through fatigue and delamination [8,36,37]. However, early polyethylene failure was related to poor material quality and oxidative degradation [38] and the development of new stabilized and enhanced polyethylene materials has had a significant impact on material performance.…”

Section: Discussionmentioning

confidence: 99%

The wear of fixed and mobile bearing unicompartmental knee replacements

Brockett

Jennings

Fisher

2011

Proc Inst Mech Eng H

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Unicompartmental knee replacements (UKR) are an option for surgical intervention for the treatment of single-compartment osteoarthritis. The aim of this study was to compare the wear of a low-conformity fixed-bearing UKR with a conforming mobile bearing UKR under two kinematic conditions, to investigate the effect of implant design and kinematics on wear performance in a physiological knee wear simulator. Under both sets of kinematic conditions, the relatively low-conforming fixed UKR showed lower wear, compared with the more conforming anterior-posterior sliding mobile bearing. However, it should be noted that differences in materials between the two designs also contribute to the relative wear performance of the bearings. The combined wear of the medial and lateral bearings of the fixed-bearing UKR as a 'total knee' were significantly reduced compared with a fixed-bearing total knee replacement studied under the same kinematic conditions.

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“…Early published outcomes of medial UKA were unfavorable with midterm revision rates of 15% to 28% [20,32,39] for aseptic loosening, polyethylene wear, and progression of arthritis to the remaining compartments. Although TKA remains the gold standard, with survivorship figures of 92% to 100% [3,15,16,25,30], more recent reports demonstrate UKA survivorship of 84% to 98% over the mid-to long term [14,16,34,35,37,44,[54][55][56][57]59].…”

Section: Introductionmentioning

confidence: 99%

Does Bearing Design Influence Midterm Survivorship of Unicompartmental Arthroplasty?

Whittaker

Naudie

McAuley

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Early Catastrophic Tibial Component Wear After Unicompartmental Knee Arthroplasty

Cited by 78 publications

References 0 publications

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

The wear of fixed and mobile bearing unicompartmental knee replacements

Does Bearing Design Influence Midterm Survivorship of Unicompartmental Arthroplasty?

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