Unicompartmental knee arthroplasty

Rodríguez-Merchán, E. Carlos; Gómez-Cardero, Primitivo

doi:10.1302/2058-5241.3.170048

Cited by 36 publications

(13 citation statements)

References 70 publications

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“…Unicompartmental knee arthroplasty is an alternative to TKR for patients whose disease is limited to a single area of the knee, particularly the isolated tibiofemoral compartment (medial or lateral). As partial knee replacement is performed using smaller incisions, patients can generally be discharged earlier than those who undergo TKR and can return sooner to normal activities, including work and sports [ 38 ].…”

Section: Surgerymentioning

confidence: 99%

Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee

Jang

Lee

2021

IJMS

300

148

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Osteoarthritis (OA) is a degenerative and chronic joint disease characterized by clinical symptoms and distortion of joint tissues. It primarily damages joint cartilage, causing pain, swelling, and stiffness around the joint. It is the major cause of disability and pain. The prevalence of OA is expected to increase gradually with the aging population and increasing prevalence of obesity. Many potential therapeutic advances have been made in recent years due to the improved understanding of the underlying mechanisms, diagnosis, and management of OA. Embryonic stem cells and induced pluripotent stem cells differentiate into chondrocytes or mesenchymal stem cells (MSCs) and can be used as a source of injectable treatments in the OA joint cavity. MSCs are known to be the most studied cell therapy products in cell-based OA therapy owing to their ability to differentiate into chondrocytes and their immunomodulatory properties. They have the potential to improve cartilage recovery and ultimately restore healthy joints. However, despite currently available therapies and advances in research, unfulfilled medical needs persist for OA treatment. In this review, we focused on the contents of non-cellular and cellular therapies for OA, and briefly summarized the results of clinical trials for cell-based OA therapy to lay a solid application basis for clinical research.

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Section: Surgerymentioning

confidence: 99%

Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee

Jang

Lee

2021

IJMS

300

148

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“…7 Medial unicompartmental arthroplasty has been associated with a shorter hospital stay, faster recovery time, lower cost, better functional outcome, and reduced perioperative morbidity and mortality compared with total knee arthroplasty. [8][9][10][11] Although several studies have reported good long-term results in single-centre series for medial unicompartmental knee arthroplasty, its survival has been inferior to that of total knee arthroplasty in national registries. 12 13 Therefore, whether patients should undergo unicompartmental or total knee arthroplasties at all is open to debate.…”

Section: Introductionmentioning

confidence: 99%

Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial

et al. 2021

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ObjectiveThe primary objective of the trial was to assess the clinical effectiveness of medial unicompartmental knee arthroplasty versus total knee arthroplasty in patients with isolated medial osteoarthritis of the knee.DesignProspective, randomised, 2 years, assessor-blind, multicentre, superiority trial.SettingThe patients were enrolled between December 2015 and May 2018 from the outpatient clinics of three public high-volume arthroplasty hospitals (Finland).ParticipantsWe recruited 143 patients with symptomatic-isolated medial osteoarthritis of the knee needing an arthroplasty procedure. All the patients were suitable for both unicompartmental and total knee arthroplasties. Population was selected as the end-stage-isolated medial osteoarthritis.InterventionsAll patients, randomized 1:1, received a medial unicompartmental arthroplasty or a total knee arthroplasty through a similar midline skin incision. Patients were blinded to the type of arthroplasty for the whole 2 years of follow-up.Main outcome measuresPrimary outcome measure was between-group differences in the Oxford Knee Score (OKS) and secondary outcome Knee injury and Osteoarthritis Score (KOOS) at 2 years postoperatively. The changes within and between the groups were analysed with analysis of variance for repeated measurements.ResultsThe primary outcome was comparable for medial unicompartmental arthroplasty and total knee arthroplasty at 2 years. The mean difference in the OKS between the groups was 1.6 points (95% CI −0.7 to 3.9). In the KOOS subscales, the mean difference between the groups was 0.1 points (95% CI −4.8 to 5.0) for pain, 7.8 points (95% CI 1.5 to 14.0) for symptoms, 4.3 points (95% CI −0.6 to 9.2) for function in daily living, 4.3 points (95% CI −3.0 to 11.6) for function in sports, and 2.1 points (95% CI −4.8 to 9.1) for knee-related quality of life.ConclusionsThe recovery after unicompartmental knee arthroplasty was faster compared with total knee arthroplasty, but unicompartmental arthroplasty did not provide a better patient-reported outcome at 2 years.Trial registration numberNCT02481427.

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“…Numerous publications are showing that UKA has a decreased complication rate and superior postoperative results compared to total knee arthroplasty (TKA) [ 3 – 8 ]. Complications of UKA include osteoarthritis progression, aseptic loosening, bearing dislocation, and pain [ 9 , 10 ]. For these complications, the recommended treatment is a revision to TKA, which is a difficult surgery.…”

Section: Introductionmentioning

confidence: 99%

Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment

Fournier

Gaillard

Swan

et al. 2021

SICOT-J

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Introduction: One of the principal complications after total knee arthroplasty (TKA) is stiffness. There are no publications concerning stiffness after unicompartmental knee arthroplasty (UKA). Study objectives were to describe the incidence of stiffness after UKA, to look for risk factors, and to describe safe and effective arthroscopic treatment. Methods: There were 240 UKA performed between March 2016 and January 2019 included. Robotic-assisted surgery was performed in 164 patients and mechanical instrumentation in 76 patients. Stiffness was defined as flexion < 90° or a flexion contracture > 10° during the first 45 post-operative days. Patients with stiffness were treated with arthroscopic arthrolysis. Several factors were studied to look for risk factors of stiffness: body mass index, gender, age, mechanical or robotic instrumentation, preoperative flexion, previous meniscectomy, and anticoagulant treatment. Arthrolysis effectiveness was evaluated by flexion improvement and UKA revision rate. Results: 22 patients (9%) developed stiffness. Mechanical instrumentation significantly increased the risk of stiffness with OR = 0.26 and p = 0.005. Robotic-assisted surgery decreased the risk of stiffness by five-fold. Before arthrolysis, mean knee flexion was 79°, versus 121° (53% improvement) after arthroscopic arthrolysis. Only 2 patients (9%) underwent UKA revision after arthrolysis. Discussion: Stiffness after UKA is an important complication with an incidence of 9% in this study. Arthroscopic arthrolysis is a safe and effective treatment with a range of motion improvement of > 50%. Robotic-assisted surgery significantly decreases the risk of postoperative stiffness. Level of evidence: Level III, therapeutic study, retrospective cohort study

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Unicompartmental knee arthroplasty

Cited by 36 publications

References 70 publications

Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee

Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee

Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial

Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment

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