Mid-Term Outcomes of Metal-Backed Unicompartmental Knee Arthroplasty Show Superiority to All-Polyethylene Unicompartmental and Total Knee Arthroplasty

List, Jelle P. van der; Kleeblad, Laura J.; Zuiderbaan, Hendrik A.; Pearle, Andrew D.

doi:10.1007/s11420-017-9557-5

Cited by 27 publications

(10 citation statements)

References 64 publications

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“…A further 36 cohort studies were included in group 3. Of these studies including data comparisons between UKAs and TKAs,15 31 82 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 only five included data specifically in patients with anteromedial osteoarthritis 1585 99 103 111 Again, we saw some crossover in the data presented from the same unit in multiple papers, but the maximum number of implants was 26 418.…”

Section: Resultsmentioning

confidence: 99%

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Wilson

Middleton

Abram

et al. 2019

BMJ

233

206

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Objective To present a clear and comprehensive summary of the published data on unicompartmental knee replacement (UKA) or total knee replacement (TKA), comparing domains of outcome that have been shown to be important to patients and clinicians to allow informed decision making. Design Systematic review using data from randomised controlled trials, nationwide databases or joint registries, and large cohort studies. Data sources Medline, Embase, Cochrane Controlled Register of Trials (CENTRAL), and Clinical Trials.gov, searched between 1 January 1997 and 31 December 2018. Eligibility criteria for selecting studies Studies published in the past 20 years, comparing outcomes of primary UKA with TKA in adult patients. Studies were excluded if they involved fewer than 50 participants, or if translation into English was not available. Results 60 eligible studies were separated into three methodological groups: seven publications from six randomised controlled trials, 17 national joint registries and national database studies, and 36 cohort studies. Results for each domain of outcome varied depending on the level of data, and findings were not always significant. Analysis of the three groups of studies showed significantly shorter hospital stays after UKA than after TKA (−1.20 days (95% confidence interval −1.67 to −0.73), −1.43 (−1.53 to −1.33), and −1.73 (−2.30 to −1.16), respectively). There was no significant difference in pain, based on patient reported outcome measures (PROMs), but significantly better functional PROM scores for UKA than for TKA in both non-trial groups (standard mean difference −0.58 (−0.88 to −0.27) and −0.29 (−0.46 to −0.11), respectively). Regarding major complications, trials and cohort studies had non-significant results, but mortality after TKA was significantly higher in registry and large database studies (risk ratio 0.27 (0.16 to 0.45)), as were venous thromboembolic events (0.39 (0.27 to 0.57)) and major cardiac events (0.22 (0.06 to 0.86)). Early reoperation for any reason was higher after TKA than after UKA, but revision rates at five years remained higher for UKA in all three study groups (risk ratio 5.95 (1.29 to 27.59), 2.50 (1.77 to 3.54), and 3.13 (1.89 to 5.17), respectively). Conclusions TKA and UKA are both viable options for the treatment of isolated unicompartmental osteoarthritis. By directly comparing the two treatments, this study demonstrates better results for UKA in several outcome domains. However, the risk of revision surgery was lower for TKA. This information should be available to patients as part of the shared decision making process in choosing treatment options. Systematic review registration PROSPERO number CRD42018089972.

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Section: Resultsmentioning

confidence: 99%

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Wilson

Middleton

Abram

et al. 2019

BMJ

233

206

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“…Magnetic resonance imaging is a valuable tool that allows the anatomical integrity of the ACL to be assessed by visualizing the entire anatomy from femoral origin to tibial insertion [ 17 ]. Multiple previous studies have evaluated the role of postoperative MRI after ACL reconstruction both after bone–patellar tendon bone (BPTB) and hamstrings grafts [ 14 , 17 ]. However, the graft maturation process is a distinctly different biological situation than the healing of the native ACL that has been repaired, and thus it is felt that the relevance to primary ACL repair is limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the last several years, some studies on ACL repair have shown good to excellent results with a failure rate ranging from 7% to 15% of cases [ 9 – 13 ]. Most articles recommend surgery within 4 weeks from injury; however, there is a wide variety of delay until treatment, including at least one case report of a patient treated 11 years after injury [ 14 ]. Since the renewal of interest in ACL primary repair has only been recent, there has been little investigation regarding MRI evaluation after ACL primary repair [ 7 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

The healing potential of an acutely repaired ACL: a sequential MRI study

Ferretti¹,

Monaco²,

Annibaldi³

et al. 2020

J Orthop Traumatol

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Background: Recently, there has been renewed interest in primary anterior cruciate ligament (ACL) repair. The aim of this study is to report early clinical and radiological results of a consecutive series of acute ACL tears treated with arthroscopic primary ACL repair within 14 days from injury. Patients and methods: A consecutive series of patients with acute ACL tears were prospectively included in the study. Based on MRI appearance, ACL tears were classified into five types, and tissue quality was graded as good, fair, and poor. Patients with type I, II, and III tears and at least 50% of ACL tibial remnant intact with good tissue quality were ultimately included. Clinical outcomes were measured using the Tegner Lysholm Knee Scoring Scale (TLKSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), subjective and objective International Knee Documentation Committee (IKDC) scores, and KT-1000. Patients were also followed up with MRI evaluations at 1, 3, and 6 months postoperatively. ACL appearance was graded based on morphology (normal or abnormal) and signal intensity (isointense, intermediate, and hyperintense). Results: The mean TLKSS was 98.1, the mean subjective IKDC was 97.6, and the mean KOOS was 98.2. The objective IKDC score was A in eight of ten patients and B in two patients. KT-1000 measurements showed a maximum manual side-to-side difference of less than 2 mm in eight of ten patients, whereas two patients showed a difference of 3 mm. The morphology of the repaired ACL was normal (grade 1) at 1 month follow-up in ten of ten cases, and this appearance persisted at 3 and 6 months postoperatively. The signal intensity at 1 month postoperatively was graded as isointense (grade 1) in four of ten patients, intermediate (grade 2) in five of ten patients, and hyperintense (grade 3) in one of ten patients. At both 3 and 6 months postoperatively, the signal intensity was graded as isointense (grade 1) in nine of ten patients and intermediate (grade 2) in one of ten patients. Conclusions: Arthroscopic primary ACL repair performed acutely in a carefully selected group of patients with proximal ACL tears and good tissue quality showed good early clinical and radiological results.

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“…The patient's expectations for knee replacement surgery have changed through the main surgical pathway strengthening, enhancement in the implants design, multiple pain strategies, enhanced surgical techniques and the implementation of the same-day surgery program. Ensuring a simpler, faster functioning and faster recovery activation process, primarily for isolated knee compartment osteoarthritis [46], can lead to a significant increase in UKA frequency. At present, some additional indicators have been extended to achieve excellent clinical results [7] [48].…”

Section: Current Trendsmentioning

confidence: 99%

Current Trends in Clinical Practice for the Minimal Invasive Medial Unicondylar Knee Arthroplasty

Sah¹,

Sinkemani²,

Li³

2020

OJO

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Unicondylar Knee Arthroplasty (UKA) is an early alternative surgical procedure for the unicondylar osteoarthritis or damaged knee joint with artificial prosthesis for the release of disabling painful condition and restoring the normal knee functions. Minimally UKA is one of the recent and the majority successful procedures in modern orthopedics for the osteoarthritis which is spreading throughout the worldwide. Recently, many orthopedic surgeons are expanding their abilities in this field. However, it needs good knowledge and well experience for the successful clinical outcomes. The minimal invasive approach is more efficient for short hospital stay and faster postoperative recovery with low morbidity of the patients after UKA. The aim of this article is to emphasize the steps in UKA based on modern facts: function of knee joint, diagnosis, less invasive approach for medial condylar replacement, radiographic evaluation, and earlier recovery, selecting the patient and implant survivorship with review of surgery.

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Mid-Term Outcomes of Metal-Backed Unicompartmental Knee Arthroplasty Show Superiority to All-Polyethylene Unicompartmental and Total Knee Arthroplasty

Cited by 27 publications

References 64 publications

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

The healing potential of an acutely repaired ACL: a sequential MRI study

Current Trends in Clinical Practice for the Minimal Invasive Medial Unicondylar Knee Arthroplasty

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