Incidence, temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96,294 knees

Barrett, Matthew; Wilkinson, Florence O.; Blom, Ashley W; Whitehouse, Michael R; Kunutsor, Setor K

doi:10.1016/j.knee.2021.04.005

Cited by 12 publications

(8 citation statements)

References 44 publications

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“…However, a more recent meta-analysis study reported high aseptic loosening in FB-UKAs, similar to our results (15). Similarly in a meta-analysis study by Barret et al (29), which included 96 294 knees, they found that aseptic loosening of the tibial component occurred at a lower rate in UKA patients who underwent cementless robotic-assisted surgery with an MB insert. Insert dislocation, an urgent complication, was the only cause of revision surgery in the MB-UKAs.…”

Section: Discussionsupporting

confidence: 91%

Sabit-İnsörtlü ve Mobil-İnsörtlü Unikondiler Diz Artroplastisi: Benzer Komponent ve Mekanik Eksen Dizilimine Sahip Hastaların Karşılaştırması

Saylık

ERGÜN>

Güneş

2022

Düzce Tıp Fakültesi Dergisi

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Aim: Unicondylar knee arthroplasty (UKA) is among the treatment options for patients with arthritis limited to one compartment of the knee. Fixed-bearing (FB) and mobile-bearing (MB) inserts are present. This study aimed to compare functional and clinical outcomes and revision rates of patients operated with FB-UKA and MB-UKA. Material and Methods: A total of 131 knees of 118 patients underwent cemented UKA, with a mean follow-up period of 80.58±31.31 months for FB-UKA and 97.66±29.24 months for MB-UKA. Clinical and functional evaluation was performed by the Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, at the last follow-up visit. The factors affecting the radiological and functional results, complication, and revision rates were examined under three main titles; i) surgeon-related, ii) patient-related, and iii) component alignment-related factors. Results: There was no significant difference between the groups in terms of age, gender, body mass index, and side. Regarding the KSS scores, 9 (6.87%) knees were within acceptable limits, 62 (47.32%) knees were found to be good, and 60 (45.80%) knees were found to be excellent. No statistically significant difference was found between groups (p=0.497). Regarding the WOMAC scores, the MB-UKA group had significantly lower pain (p=0.049) and stiffness (p=0.014), but similar functional (p=0.591) scores. There was no statistically significant difference regarding revision rates (p=0.931). Conclusion: Similar clinical, functional, and radiological results and low revision rates were found. In terms of pain and joint stiffness, a significant difference was found between groups, in favor of MB-UKA.

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Section: Discussionsupporting

confidence: 91%

Sabit-İnsörtlü ve Mobil-İnsörtlü Unikondiler Diz Artroplastisi: Benzer Komponent ve Mekanik Eksen Dizilimine Sahip Hastaların Karşılaştırması

Saylık

ERGÜN>

Güneş

2022

Düzce Tıp Fakültesi Dergisi

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“…Prosthesis aseptic loosening is a key complication that is worthy of attention, especially in people with haemophilia. The incidence of aseptic loosening after the first TKA is 1-23% for ordinary people without haemophilia [28,29]. The young age, poor bone quality, microhaemorrhages, and prevalence of osteoporosis [30] in patients with haemophilia are strongly associated with prosthesis loosening.…”

Section: Prosthesis Aseptic Looseningmentioning

confidence: 99%

Total knee arthroplasty in patients with haemophilic arthropathy is effective and safe according to the outcomes at a mid-term follow-up

Wang

et al. 2022

J Orthop Traumatol

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Background Haemophilic arthropathy (HA), a common complication of haemophilia, is secondary to recurrent joint bleeding and increases the prevalence of end-stage osteoarthritis (OA). Total knee arthroplasty (TKA) is a reliable treatment for haemophilia patients. This study was performed to evaluate the mid-term outcomes of TKA for end-stage HA. We hypothesized that the rate of complications of TKA is higher for patients with haemophilia than for patients without haemophilia. Methods Patients with HA undergoing TKA from January 2015 to December 2016 in our centre were retrospectively reviewed. All patients were managed by a multidisciplinary team. The improvements in flexion contracture, range of motion (ROM), Knee Society Score (KSS; clinical and functional), Visual Analogue Scale (VAS) score, and satisfaction at final follow-up were analysed to evaluate the effectiveness of TKA in HA. The complications were analysed to evaluate the safety of TKA in HA. Results Twenty-eight patients (32 knees) were included in the study. The follow-up was 69.1 ± 5.1 months. Significant differences between the preoperative and final follow-up values of flexion contracture (which changed from 21.1 ± 6.5° to 14.3 ± 4.1°, P < 0.001), ROM (from 53.9 ± 15.0° to 70.3 ± 16.3°, P < 0.001), clinical KSS (from 33.5 ± 14.4° to 62.7 ± 9.5°, P < 0.001), functional KSS (from 46.1 ± 15.5° to 62.9 ± 9.7°, P < 0.001), and VAS score (from 6.8 ± 1.4 to 4.9 ± 1.3, P < 0.01) were observed. Importantly, the incidence of complications was 15.6% and the satisfaction was 100% in our mid-term study. Conclusion Under elaborative and comprehensive management, TKA is effective and safe in patients with advanced HA on the basis of mid-term follow-up outcomes.

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“…Cementless knee arthroplasties have shown lower risk of aseptic loosening compared to the cemented versions. 8,15 However, given the same cement technique for both ZUK and AUK, this finding may have little bearing on the difference in aseptic loosening rates observed between the two groups in this study.…”

Section: Discussionmentioning

confidence: 76%

Retrospective comparison of rates of aseptic loosening in fixed-bearing unicompartmental knee arthroplasty (UKA) implants

Boucher

Hawken

Lee

et al. 2022

Current Orthopaedic Practice

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Background:A prominent cause for failure and revision in unicompartmental knee arthroplasty (UKA) is aseptic implant loosening. This study compared the revision rates for aseptic loosening of a new UKA implant, Aesculap Univation X (B. Braun, Tuttlingen, Germany), versus a well-established standard design, Miller Galante (Zimmer, Warsaw, Indiana). Methods:Patient charts were retrospectively reviewed of medial UKAs performed using two different fixed-bearing UKA implants from different manufacturers between January 1, 2002, and November 6, 2020. Of 308 patients included in the study, 44 had the new implant (AUK) and 264 patients had a standard implant (ZUK). The revision rates for all-cause and aseptic loosening were compared. The Kaplan Meier curve for 5-year survival rate was calculated based on aseptic loosening as the cause of failure. Hazard ratios for failure were calculated with multivariable Cox regression analysis. Results:All-cause revision and revision from aseptic loosening were significantly higher for AUK versus ZUK (20% versus 5.30% and 18.18% versus 3.41%, respectively). The log-rank test showed significantly longer survival for ZUK versus AUK group (P < 0.001). Multivariable Cox regression analysis found a hazard ratio of 21.62 (95% CI: 4.07, 114.72; P < 0.001) for revision for the AUK versus ZUK group, controlling for sex, age, and body mass index. Conclusions:Among these patients, AUK had lower survivorship than the established implant, ZUK, due to significantly higher hazard of all-cause revision and revision from aseptic loosening. These findings suggest a need for caution with use of this new implant.

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Incidence, temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96,294 knees

Cited by 12 publications

References 44 publications

Sabit-İnsörtlü ve Mobil-İnsörtlü Unikondiler Diz Artroplastisi: Benzer Komponent ve Mekanik Eksen Dizilimine Sahip Hastaların Karşılaştırması

Sabit-İnsörtlü ve Mobil-İnsörtlü Unikondiler Diz Artroplastisi: Benzer Komponent ve Mekanik Eksen Dizilimine Sahip Hastaların Karşılaştırması

Total knee arthroplasty in patients with haemophilic arthropathy is effective and safe according to the outcomes at a mid-term follow-up

Retrospective comparison of rates of aseptic loosening in fixed-bearing unicompartmental knee arthroplasty (UKA) implants

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