Early Results of a Randomized Controlled Trial of Partial Versus Total Knee Arthroplasty

Sershon, Robert A.; Fricka, Kevin B.; Hamilton, William G.; Nam, Dennis; Parks, Nancy L.; DeBenedetti, Anne; Valle, Craig J. Della

doi:10.1016/j.arth.2022.02.076

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…After 6 months of treatment, the total working extension value and flexion of knee joint in UKA group were significantly higher than those in TKA group. Sershon et al [ 7 ] found that patients treated with UKA had shorter hospital stay and greater range of early knee movement, and short-term complications may be more common in TKA. The implementation of the double-side single condylar knee arthroplasty can effectively reduce the patient's bleeding and hospital stay and less postoperative morbidity [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Periarticular Injection Cocktail in Postoperative Analgesia after Bilateral Unicompartmental Knee Arthroplasty

Wang¹,

Zhao

Guo

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This study was conducted to compare postoperative pain and functional recovery in bilateral unicompartmental knee arthroplasty (UKA) and unilateral UKA after cocktail therapy. Methods. A total of 240 patients who received unilateral UKA and bilateral UKA in our orthopedic department from February 2019 to April 2020 were collected. The general clinical data was recorded and compared between the two groups of subjects, and the time of postoperative landing was recorded separately for both groups. A visual analogue scale (VAS) was used to record the patients’ pain at 1, 7, and 14 days postoperatively, as well as the range of motion of the affected limb at 1, 7, 14 days, and 3 months postoperatively and the hospital for special surgery (HSS) knee score of the knee at 1 month postoperatively. Results. After cocktail injection analgesia, unilateral patients with knee surgery got off the ground and walked significantly earlier than patients with bilateral surgery, while there was no significant difference between the two groups in terms of pain at 1, 7, and 14 days after surgery, range of motion of the affected limb at 1, 7, 14 days, and 3 months after surgery, and knee HSS score at 1 month after surgery. Conclusion. Periarticular cocktail injection significantly reduces postoperative pain in patients, and bilateral UKA surgery can be used as satisfactory as unilateral UKA in clinical practice.

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Section: Introductionmentioning

confidence: 99%

The Effects of Periarticular Injection Cocktail in Postoperative Analgesia after Bilateral Unicompartmental Knee Arthroplasty

Wang¹,

Zhao

Guo

et al. 2022

Computational and Mathematical Methods in Medicine

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“…In an RCT, patient-reported outcome measures (PROMs) and opioid consumption were not significantly different between both procedures at the 6-week follow-up. However, UKAs had significantly better range of motion and shorter operative time and length of stay 8 . A matched comparison between cementless UKA and TKA showed that, at 6 months postoperatively, UKAs had a significantly greater proportion of excellent Oxford Knee Scores and a lower proportion of poor scores 9 .…”

Section: Ukamentioning

confidence: 89%

What’s New in Adult Reconstructive Knee Surgery

Villa

Singh

Higuera-Rueda

2022

Journal of Bone and Joint Surgery

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Over the past year, areas of investigation in total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) such as bleeding control, thromboprophylaxis, pain management, technology-assisted surgery, and infection received major attention. We have included selected studies, many at the highest Levels of Evidence, in an attempt to summarize the most relevant recent findings. Economics of Added TechnologyAhmed et al. 1 evaluated the adoption of computer-assisted knee arthroplasty between the first quarter of 2010 and the third quarter of 2017 in the states of New York and Florida, making use of 2 statewide administrative databases (the Statewide Planning and Research Cooperative System in New York and the Florida Administrative Data in Florida). The proportion of computerassisted knee arthroplasty increased from 4.89% to 9.45% in New York, and from 4.03% to 5.73% in Florida. In New York, that represented a 93.3% growth in utilization. One of the reasons preventing the widespread adoption of these new technologies is their increased costs. In a Markov model, Rajan et al. 2 ascertained the cost-effectiveness of robotic-assisted TKA compared with conventional TKA. Robotic-assisted TKA produced 13.55 qualityadjusted life-years (QALYs) compared with 13.29 QALYs for conventional TKA. Because of its higher QALYs, robotic-assisted TKA remains cost-effective despite being associated with higher costs as long as annualized revision rates stay <1.6%. The costutility of patient-specific instrumentation for TKA compared with the standard of care among patients with a body mass index (BMI) of >30 kg/m 2 was evaluated; patient-specific instrumentation was more costly and less effective 3 . A secondary analysis of a randomized clinical trial (RCT) comparing closed-incision, negative-pressure therapy with the standard of care after revision TKA revealed that the total per-patient costs for surgical-site management were $1,047 for closed-incision, negative-pressure therapy and $2,036 for the standard of care 4 . Knee OsteoarthritisGenetic markers seem to play a role in advanced knee osteoarthritis. Utilizing clinical and genomic data, investigators showed that age and BMI contributed more to the risk of developing end-stage disease than genetic factors. However, 7 genetic loci were significantly associated with end-stage osteoarthritis. The effects of genetic factors were greater in patients who were <60 years of age 5 . The use of hyaluronic acid and platelet-rich plasma remains controversial. Among Medicare patients, hyaluronic acid utilization increased from 1,090,503 patients in 2012 to 1,209,489 patients in 2018 (p = 0.04), and total costs related to hyaluronic acid services increased from $290.10 million to $325.02 million (p < 0.01) 6 . In patients with hemophilic knee arthritis, a trial compared the effects of platelet-rich plasma injections with those of placebo on outcomes over a 24-month follow-up. There were no clinically important differences in the Western Ontario and McMaster Universities Osteoarthritis I...

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“…Most published studies are retrospective or underpowered and are majorly reported in the Caucasian population [ 14 , 18 , 29 – 38 ]. Only a few studies have incorporated PROMs in the outcomes assessed [ 29 , 31 – 33 , 39 , 40 ]. No studies are comparing patient-reported outcomes along with patellofemoral outcomes and satisfaction after UKA or TKA for AMOA in the Asian ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Partial versus total knee arthroplasty for isolated antero-medial osteoarthritis – An analysis of PROMs and satisfaction

Annapareddy

Mulpur

Prakash

et al. 2023

SICOT-J

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Aim: This study aimed to compare the patient-reported functional outcomes and patient satisfaction after medial Unicompartmental Knee Arthroplasty (UKA) versus Total Knee Arthroplasty (TKA), performed for anteromedial osteoarthritis (AMOA) of the knee in patients from an Indian population, at a minimum 3-year follow-up. Methods: This is a prospective matched cohort study (1:2 ratio). One hundred and one UKA cases were matched to 206 TKA cases by propensity score matching for age, body mass index (BMI), gender distribution, and the Charlson Comorbidity Index (CCI). The primary outcome (Oxford knee score, OKS) was assessed at a 3-year follow-up, along with secondary outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Score, Forgotten Joint Score (FJS), Anterior Knee Pain (Kujala) score, patient satisfaction, and revision rate at the final follow-up). Results: The UKA group was superior to the TKA group in patient-reported functional outcomes based on the OKS (p = 0.004). Using the FJS score, UKA was more likely to be a forgotten joint compared to TKA (p < 0.001). However, differences in the OKS and FJS did not meet the reported minimal clinically important difference (MCID) thresholds. Quality of life (EuroQol-5D VAS scale) was found to be significantly higher in the UKA group (p < 0.001). Patients in the UKA group were more likely to be very satisfied (75.2%) versus the TKA group (62.1%, p = 0.023). Conclusion: For AMOA, UKA was associated with improved patient satisfaction compared to TKA. Although patient-reported outcome measures were statistically in favour of UKA over TKA, the differences were not clinically significant. Multicenter and randomized studies comparing the two procedures are warranted. Evidence: Level-II Therapeutic

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Early Results of a Randomized Controlled Trial of Partial Versus Total Knee Arthroplasty

Cited by 14 publications

References 30 publications

The Effects of Periarticular Injection Cocktail in Postoperative Analgesia after Bilateral Unicompartmental Knee Arthroplasty

The Effects of Periarticular Injection Cocktail in Postoperative Analgesia after Bilateral Unicompartmental Knee Arthroplasty

What’s New in Adult Reconstructive Knee Surgery

Partial versus total knee arthroplasty for isolated antero-medial osteoarthritis – An analysis of PROMs and satisfaction

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