Medial Tibial Plateau Fracture Complicating Unicompartmental Knee Arthroplasty

Rudol, G.; Jackson, Mark; James, Stephen E.

doi:10.1016/j.arth.2006.01.005

Cited by 43 publications

(30 citation statements)

References 8 publications

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“…[6,13,19] This was attributed to strict patient selection, improved prosthetic design, and minimally invasive surgery. [7,13,[21][22][23][24][25] In the present study, the functional outcome of the knee was normal in 51%, nearly normal in 37%, abnormal in 8%, and severely abnormal in 4%. Approximately 98% of the patients were satisfied with the surgery.…”

Section: Discussionmentioning

confidence: 93%

Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

Wong¹,

Wang²,

Wang³

et al. 2014

Biomed J

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Background: Uni-knee arthroplasty (UKA) has shown better knee kinematics and motion that may better suit the activities of daily living in Eastern countries. The purpose of this study was to evaluate the functional outcomes of UKA for medial compartment knee arthropathy in Asian patients. Methods:The study cohort consisted of 48 patients with 51 UK A knees. Only one type of prosthesis was used and all components were cemented. Postoperative management included ambulation with weight bearing, range of motion, and muscle strengthening exercises as tolerated until full recovery. The average follow-up was 52.0 ± 24.0 (range 12-92) months. The evaluation included functional assessment, the Knee Society knee and functional scores, the International Knee Document Committee (IKDC) subjective and objective scores, and radiographs of the knee. Results:The overall clinical outcomes of the knee showed the functional outcome of the knee to be normal in 51%, nearly normal in 37%, abnormal in 8%, and severely abnormal in 4%. The functional activities included stair climbing in 96%, squatting in 76%, jogging in 71% and kneeling in 47%. Three-quarters of the patients were able to kneel for daily activities. Approximately 98% of the patients were satisfied with the operation. The survivorship of the prosthesis was 98% with one revision pending. Radiographic evaluations revealed the components were centered in 82% and off-centered in 18%. Osteoarthritis was 22% preoperative and 27% postoperative for the patellofemoral compartment, and 0% before and 4% after surgery for the lateral compartment. The functional outcomes showed no difference between patients with and without patellofemoral arthritis. The complications included one component malposition and one knee pain of undetermined origin. Conclusions: UKA provides excellent pain relief and restoration of knee function including kneeling, squatting, and sit-to-stand activities that perfectly fit the oriental lifestyle and high patient satisfaction in Asian patients at medium-term follow-up. The complications were rare and the survival rate was 98% at medium-term follow-up. (Biomed J 2014;37:406-410)

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Section: Discussionmentioning

confidence: 93%

Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

Wong¹,

Wang²,

Wang³

et al. 2014

Biomed J

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“…This is a rare complication of cemented OUKR and is normally associated with errors in technique. [33][34][35] In cadaveric studies, a lower load is required to generate a peri-prosthetic fracture in tibiae implanted with a cementless implant than those implanted using cement. 36 Although the rate of further operation and revision in this series is equivalent to those of previous series of the cemented OUKR, there were four peri-prosthetic fractures in this cohort.…”

Section: Discussionmentioning

confidence: 98%

Cementless fixation in Oxford unicompartmental knee replacement

Liddle

Pandit

O’Brien

et al. 2013

The Bone & Joint Journal

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The Cementless Oxford Unicompartmental Knee Replacement (OUKR) was developed to address problems related to cementation, and has been demonstrated in a randomised study to have similar clinical outcomes with fewer radiolucencies than observed with the cemented device. However, before its widespread use it is necessary to clarify contraindications and assess the complications. This requires a larger study than any previously published. We present a prospective multicentre series of 1000 cementless OUKRs in 881 patients at a minimum follow-up of one year. All patients had radiological assessment aligned to the bone-implant interfaces and clinical scores. Analysis was performed at a mean of 38.2 months (19 to 88) following surgery. A total of 17 patients died (comprising 19 knees (1.9%)), none as a result of surgery; there were no tibial or femoral loosenings. A total of 19 knees (1.9%) had significant implant-related complications or required revision. Implant survival at six years was 97.2%, and there was a partial radiolucency at the bone-implant interface in 72 knees (8.9%), with no complete radiolucencies. There was no significant increase in complication rate compared with cemented fixation (p = 0.87), and no specific contraindications to cementless fixation were identified. Cementless OUKR appears to be safe and reproducible in patients with end-stage anteromedial osteoarthritis of the knee, with radiological evidence of improved fixation compared with previous reports using cemented fixation.

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“…Attempts to manage the fractures in two of the cases through fixation and bracing failed, and eventually conversion to TKA for pain relief was necessary. Other case reports of tibial plateau fractures in the literature confirm that this complication is usually due to surgical technique [43,45,46]. The authors speculate that extended vertical saw cuts are the most frequent cause of the fractures.…”

Section: Complicationsmentioning

confidence: 88%

“…Pinholes should be minimized and extended sagittal cuts should be avoided. Proper sizing of the tibial component is required as both oversizing and undersizing can lead to stress fractures that propagate through the plateau [42][43][44][45][46];…”

Section: Conventional Surgical Approach and General Guidelinesmentioning

confidence: 99%

Scientific evidence for the use of modern unicompartmental knee arthroplasty

Maduekwe

Zywiel

Bonutti

et al. 2010

Expert Review of Medical Devices

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Unicompartmental knee arthroplasty as a surgical treatment for monocompartmental knee arthritis remains a controversial procedure with questions surrounding the benefits and survivorship of the procedure versus osteotomies or total knee arthroplasties. The authors, by examining the complete body of literature for scientific evidence concerning the procedure, will describe the history of usage of these prostheses, their rationale for usage, modern devices and their results, and why they may have advantages as a treatment modality for monocompartmental knee arthritis. Outcomes of current unicompartmental designs will be presented and evaluated to determine which aspects of the design and patient selection technique are associated with success or failure. Commonly asked questions regarding the use of these devices will be addressed. The authors will also describe some potential modifications that might affect the use of these components in the future, including minimally invasive procedures and robotics, and how these devices may change over the next 5 years.

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Medial Tibial Plateau Fracture Complicating Unicompartmental Knee Arthroplasty

Cited by 43 publications

References 8 publications

Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

Cementless fixation in Oxford unicompartmental knee replacement

Scientific evidence for the use of modern unicompartmental knee arthroplasty

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