Early Failure of Unicompartmental Knee Arthroplasty Leading to Revision

Aleto, Thomas; Berend, Michael E.; Ritter, Merrill A.; Faris, Philip M.; Meneghini, R. Michael

doi:10.1016/j.arth.2007.03.020

Cited by 170 publications

(123 citation statements)

References 18 publications

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“…Besides MTC, we noted femoral component loosening in 4 patients, and femoral component fracture in 1 patient. In cases of MTC, bony defects were significantly greater, and implant requirements were more increased than in cases of other modes of failures (8). We noted MTC in all of the cases.…”

Section: Discussionmentioning

confidence: 68%

“…The reasons for the revision of UKA to TKA are the followings: component loosening (8,23), progressive arthritis in patellofemoral joint (9,10) in lateral tibiofemoral joint (17,24), PE wear (8,25), tibia plateau fracture, stress fracture (10,25), infection (2,26), and persistent pain (17,26).…”

Section: Discussionmentioning

confidence: 99%

“…Aleto (8) has reported that anterior tibial collapse is associated with decrease in TS, and posterior tibial collapse is associated with increase in it. Medial tibial plateau collapse (MTC) is often the reason of failure in all-poly UKAs.…”

Section: Discussionmentioning

confidence: 99%

“…Several articles have been published about the range of acceptable components' malalignment (3)(4)(5)(6)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

Zsakai¹,

Nadianmehr²,

Oláh³

et al. 2017

Trauma Mon

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Background: The (UKA) is performed as an alternative to total knee arthroplasty (TKA) and high tibial osteotomy for unicompartmental osteoarthritis. Objectives: We examined whether the tolerable range of component malalignment is narrower in obese (BMI > 30) than in nonobese patients. Methods: We performed 163 consecutive all-poly medial UKA from 01/01/1995 to 31/10/2003. We examined 83 patients (88 knees) at a minimal follow-up period of 10 years. We examined the correlation between limb-and component malalignment and clinical outcome separately in the obese (67 knees) and nonobese (21 knees) group. Results: The 10-year prothesis survival was 92.8%, and 9 UKA were converted to total knee arthroplasty. The average time to revision was 84.44 (48 to 144) months. The 8 obese and 1 nonobese patients had slightly higher BMI (33.47) than the 83 long-term followed patients (31.72). In each of these 9 patients, knee score and functional score were poor. At every revision, we used stems and augments. In the obese group, the prosthetic joint space depression correlated with fair and poor knee and functional scores, the prosthetic joint space elevation is correlated with degenerative changes in lateral tibiofemoral joint. Conclusions:In the obese group, we noted at least 2 mm of prosthetic joint space depression in all of the 8 failured knees, and 4 mm or more than 4 mm in 6 cases. We hypothesize that the reason fot the subsidence of tibial component is the increased loading because of prosthetic joint space depression. The result of this study suggests that tibial component positioning which provides an optimal level of prosthetic joint space reduces the risk of failure in medial UKA, prevents degenerative changes in lateral tibiofemoral joint, and provides better long-term clinical outcome.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Several articles have been published about the range of acceptable components' malalignment (3)(4)(5)(6)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

Zsakai¹,

Nadianmehr²,

Oláh³

et al. 2017

Trauma Mon

View full text Add to dashboard Cite

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“…Improper patient selection and biomechanically unfavourable implant design have both been implicated. However, inaccurate implant positioning and secondary mechanical-axis malalignment appear to be the most common technical errors compromising the longevity of the implant [6,7]. Proper alignment of both implant components has been shown to be the major limiting factor during medial UKA, accounting for early failure of the implant [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Navigated lateral unicompartmental knee arthroplasty — Technique and case report

et al. 2009

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AbstractLateral unicompartmental knee arthroplasty (UKA) outcomes have been inferior to those described after medial UKA. Inaccurate implant positioning and mechanical axis malalignment appear to be the most common technical errors. Rare studies or failure identification on lateral UKA are currently presented in the literature. We describe the utilization of computer-assisted lateral UKA placement for lateral knee osteoarthritis with a valgus malalignment of 10°. Navigation allows for a dynamic intraoperative visualisation of the mechanical axis, as well as for accurate component positioning and overall postoperative limb alignment. The systems allow the knee position to be captured with appropriate tension in extension and flexion prior to making definite cuts. Postoperatively, no instabilities occurred with a precise component placement. Navigation can be used in rare cases for lateral UKA.

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Oxford medial unicompartmental knees display contact‐loss during step‐cycle motion and bicycle motion: A dynamic radiostereometric study

Horsager

Kaptein

Jørgensen

et al. 2017

Journal Orthopaedic Research

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The Oxford medial unicompartmental knee is designed fully congruent, with the purpose of maintaining a large contact-area throughout motion and minimize wear. No other study has investigated this design feature in-vivo. We aimed to evaluate if contact-loss was introduced between the articulating surfaces of the Oxford medial unicompartmental knee during bicycle- and step-cycle motion, and whether this correlated with essential implant parameters, such as polyethylene (PE) wear, knee-loadings, and clinical outcome. To study contact-loss, 15 patients (12 males, mean age 69 years) with an Oxford medial unicompartmental knee (7 cemented, mean follow-up 4.4 years) were examined with use of dynamic radiostereometry (RSA) (10 frames/s). PE wear was measured from static RSA and clinical outcome was evaluated with American Knee Society Score (AKSS) and Oxford Knee Score (OKS). Data on knee-loadings were acquired from the literature. Contact-loss was deteced in all patients during both exercises, and the trend of contact-loss correlated with the knee-loadings. Median contact-loss was 0.8 mm (95%PI: 0.3; 1.5) for bicycle motion and 0.3 mm (95%PI: 0.24; 0.35) for step-cycle motion, and did not correlate with the PE wear rate of mean 0.06 mm/year. Possible in-congruency was seen in three patients. Clinical outcome scores correlated with contact-loss during step-cycle motion. In conclusion, contact-loss was seen in all patients indicating a clinical tolerance during load. Contact-loss followed the knee-loadings, which could explain why no correlation was seen with PE wear, as an increase in load was acommadated by an increase in contact-area (contact-loss reduction). The size of contact-loss may reflect clinical outcome. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:357-364, 2018.

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Early Failure of Unicompartmental Knee Arthroplasty Leading to Revision

Cited by 170 publications

References 18 publications

Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

Navigated lateral unicompartmental knee arthroplasty — Technique and case report

Oxford medial unicompartmental knees display contact‐loss during step‐cycle motion and bicycle motion: A dynamic radiostereometric study

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