The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study

Peersman, Geert; Verhaegen, Jeroen; Favier, Barbara

doi:10.1007/s00264-019-04342-w

Cited by 32 publications

(31 citation statements)

References 48 publications

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“…After screening the titles and abstracts, 44 related studies were first screened out. After conducting a full-text review on the remaining studies, 13 studies were left in the final analysis, including 4 RCTs and 9 non-RCTs (cohort and case-control studies) [3,5,9,12,13,[23][24][25][26][27][28][29][30].…”

Section: Study Selectionmentioning

confidence: 99%

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Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

Deng

Zhang

et al. 2021

Arch Orthop Trauma Surg

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Background Since the optimal surgery for isolated medial knee osteoarthritis (OA) is unclear, this study aimed at comparing the effectiveness of unicondylar knee replacement (UKR) with total knee replacement (TKR) for simple medial knee OA. Methods Literature searches of PubMed, Embase, Web of Science, and the Cochrane Library were searched up to 1th April 2020. Only studies comparing UKR with TKR for isolated medial knee OA were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results A total of 13 articles with 1888 patients were included, among which, 944 and 944 underwent UKR and TKR, respectively. The analyzed postoperative outcomes were mostly within 5 years of follow-up. The meta-analysis showed that UKR improved knee general function (P < 0.00001) and health (P = 0.02), moreover, reduced post-operative pain (P = 0.01) and complications (P < 0.05) more than TKR. There were no significant differences in postoperative revision (P = 0.252), high-activity arthroplasty score (HAAS) (P = 0.307) and Oxford knee score (OKS) (P = 0.15) between the two techniques. Conclusions The patients of UKR could achieve better clinical results than that of TKR, moreover, there were negligible differences between the two techniques in postoperative revision in the early and mid-term follow-up and surgeons should be aware of the important reasons for revision of UKR. Thus, UKR instead of TKR should be performed in patients with late-stage isolated medial knee OA.

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Section: Study Selectionmentioning

confidence: 99%

“…Unicondylar knee replacement (UKR) and total knee replacement (TKR) are two major surgical options for medial knee OA. In UKR, only the damaged knee compartment is replaced, while, in TKR the total knee compartment is replaced [5].…”

Section: Introductionmentioning

confidence: 99%

Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

Deng

Zhang

et al. 2021

Arch Orthop Trauma Surg

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“…Stempin et al conducted a study to evaluate the medium-term outcome of cementless, mobile-bearing, unicompartmental knee arthroplasty and found a FJS of 75.5 (SD 5.5) after 5 years [ 54 ]. Peersmann et al evaluated patients in a prospective cohort study and found UKA patients with a FJS of 91.3 (range 85.3–97.3) to be less aware of their joint replacements than TKA patients with a FJS of 54.8 (range 49.3–60.2) 1 year after implantation [ 55 ]. Therefore implant survival rates and patient satisfaction in the present study are comparable to the highest levels reported for standard, non-customized UKA implant models in literature.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome after patient-specific unicondylar knee arthroplasty for unicompartmental knee osteoarthritis

Freigang¹,

Rupp²,

Pfeifer³

et al. 2020

BMC Musculoskelet Disord

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Background Unicondylar knee arthroplasty was introduced in the late 1960s and remains a topic of controversial discussion. Patient-specific instruments and patient-specific implants are not yet the standard of care. The question remains whether this time-consuming and costly technique can be beneficial for the patient. The aim of this study was to evaluate whether a custom-made unicondylar knee arthroplasty leads to improved patient-reported outcome. Methods This retrospective study evaluates the patient-reported outcome after custom-made unicondylar knee arthroplasty (CM-UKA, ConforMIS™ iUni® G2, ConforMIS Inc., Billerica, MA, USA). We evaluated 29 patients (31 knees) at an average of 2.4 years (range 1.2–3.6 years) after operation for unicondylar osteoarthritis of the knee. The target zone for the postoperative leg axis was a slight under-correction of 0–2° varus. Follow-up evaluation included the Forgotten Joint Score (FJS), the Knee Society Score (KSS), a Visual Analogue Scale (VAS) and a radiographic evaluation including a long-leg radiograph. Primary outcome measure was patient satisfaction based on the Forgotten Joint Score. Results We found an excellent postoperative health-related quality of life with a mean FJS of 76.8 (SD 17.9) indicating a low level of joint awareness after CM-UKA. The mean preoperative KSS was 66.0 (SD 13.71) and 59.4 (17.9) for the KSS function score. The increase was 22.8 points for the KSS knee score (p < 0.0001) and 34.8 points for the KSS function score (p < 0.0001). The VAS for pain decreased from a mean of 5.4 (SD 1.8) to 1.1 (SD 1.2) (p < 0.0001). The malalignment rate with a postoperative deviation of more than 2° in the leg axis was 29%. There was no evidence of component loosening after a mean follow-up of 2.4 years. Conclusions Custom-made unicondylar knee arthroplasty (CM-UKA) can provide improved clinical and functional outcomes for patients with isolated knee osteoarthritis of the medial compartment. We found excellent results regarding patient satisfaction and a low malalignment rate for CM-UKA. Further studies are needed to investigate long-term survivorship of the implant. Level of evidence Level IV. Trial registration Trial Registration number: Z-2014-0389-10 Regensburg Clinical Studies Center (REGCSC) 09/07/2014.

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“…Presently, UKA serves as a viable surgical alternative to total knee arthroplasty (TKA) when joint degeneration is limited to either the medial or lateral tibiofemoral compartment. Though UKA has undergone periods of criticism since its inception, namely, questioning its survival in comparison to TKA [ 4 , 5 ], it may offer faster recovery [ 6 , 7 , 8 ], reduced complication rates [ 7 , 8 , 9 , 10 ], improved patient-reported functional outcomes [ 11 , 12 , 13 ], and a more normal feeling knee [ 14 , 15 ] in appropriately selected patients. The importance of continuing to study UKA and its technological developments is highlighted by the significant and increasing healthcare burden that osteoarthritis (OA) poses across the world and the increasing number of patients with OA-related knee disorders who seek to maintain a high level of activity [ 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

Pumilia

Schroeder

Sarpong

et al. 2021

JPM

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Customized unicompartmental knee arthroplasty (C-UKA) utilizes implants manufactured on an individual patient basis, derived from pre-operative computed tomography images in an effort to more closely approximate the natural anatomy of the knee. The outcomes from 349 medial and lateral fixed-bearing C-UKA were reviewed. Implant survivorship analysis was conducted via retrospective chart review, and follow-up analysis was conducted via a single postoperative phone call or email. The rate of follow-up was 69% (242 knees). The average age at surgery was 71.1 years and the average body mass index was 28.8 kg/m2. Seven revision arthroplasties (2.1%) had knowingly been performed at an average of 1.9 years postoperatively (range: 0.1–3.9 years), resulting in an implant survivorship of 97.9% at an average follow-up of 4.2 years (range: 0.1–8.7) and 97.9% at an average of 4.8 years (range: 2.0–8.7) when knees with less than two years of follow-up were excluded. The reasons for revision were implant loosening (one knee), infection (two knees), progression of osteoarthritis (two knees), and unknown reasons (two knees). The average KOOS, JR. interval score was 84 (SD: 14.4). Of those able to be contacted for follow-up analysis, 67% were “very satisfied,” 26% were “satisfied,” 4% were “neutral,” 2% were “dissatisfied,” and 1% were “very dissatisfied.” When asked if the knee felt “natural,” 60% responded with “always,” 35% responded with “sometimes,” and 5% responded with “never.” After analyzing a large cohort of C-UKA, we found favorable rates of survivorship, satisfaction, and patient-reported functional outcomes.

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The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study

Cited by 32 publications

References 48 publications

Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

Patient-reported outcome after patient-specific unicondylar knee arthroplasty for unicompartmental knee osteoarthritis

Patient Satisfaction, Functional Outcomes, and Implant Survivorship in Patients Undergoing Customized Unicompartmental Knee Arthroplasty

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