Unicondylar vs. total knee arthroplasty in medial osteoarthritis: a retrospective analysis of registry data and functional outcome

Liebensteiner, Michael; Köglberger, Paul; Ruzicka, Alexander; Giesinger, Johannes; Oberaigner, Wilhelm; Krismer, Martin

doi:10.1007/s00402-020-03377-8

Cited by 12 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even though there is a growing number of studies underlining the better clinical and functional outcome of UKA, there are also reports showing no bene t of UKA over TKA. However, these studies demonstrate at least equal functional results [ 20,21 ]. Further reported advantages of UKA include a shorter length of hospital stay, a lower blood loss and accordingly lower transfusion rates as well as lower overall costs [ [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

Tille¹,

Beyer²,

Auerbach

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundUnicompartmental knee arthroplasty (UKA) is an established treatment option for patients with unicompartmental osteoarthritis (OA). However, strict patient selection is crucial for its success. The proposed advantages include nearly natural knee kinematics, faster rehabilitation and better functional outcomes. Despite these facts and it’s proven cost-effectiveness, there are hesitations for the use of UKA as an alternative to total knee arthroplasty (TKA). Key objectives of this study were therefore to assess clinical and patient-reported-outcome (PRO) as well as patient’s satisfaction after medial UKA in comparison to TKA. MethodsTo assess the outcome after UKA we conducted a prospective multi-center study. 116 patients with unicompartmental OA and indication for UKA were included. Overall 54 females and 62 males with an average age of 62.7 years (±9.8) and an average body mass index (BMI) of 29.2 (± 3.7) were recruited. Clinical results and PRO were assessed using the Knee Society Score (KSS). Follow-ups took place 3 months, 1 and 2 years after surgery including clinical examination, radiographs, assessment of PRO and adverse events. Pain and satisfaction were evaluated using a visual analog scale (VAS, 0 (worst) to 10 (best)).For comparison with TKA a propensity score matched-pair analysis was performed to eliminate confounders. Matching criteria were gender, patient´s age, BMI and comorbidities. A total of 116 matched-pairs were analysed. ResultsThere was no revision in the UKA group until 2 years after surgery. Revision rates were higher in the TKA group (0.6%).Preoperative KSS-Scores were higher within the UKA cohort (p < 0.001). After surgical treatment, PROMs displayed a significant improvement (p < 0,001) in both cohorts. Regarding the Knee-Score (Pain, Alignment, ROM) we observed no differences between cohorts after 12 months. The Function-Score demonstrated significantly better results in the UKA cohort (UKA vs. TKA 95 vs 80, p < 0.001). Patient satisfaction was higher in UKA patients (UKA vs TKA 9.0 vs 8.8, p = 0.019).ConclusionPatients of both cohorts showed high satisfaction after knee arthroplasty. UKA resulted in higher function scores compared to TKA without increased revision rate during short-term follow-up. Therefore, UKA is a good treatment option for unicompartmental OA. Trial registrationClinicaltrials.gov, NCT04598568. Registered 22 October 2020 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/record/NCT04598568?cond=balanSys+Uni&draw=2&rank=1

show abstract

Section: Discussionmentioning

confidence: 99%

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

Tille¹,

Beyer²,

Auerbach

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The tibial rotational angle relative to the femur at the maximum extension was set to 0°, considering a registration error of image-free navigation. From among the rotational kinematics data, we presented the following three parameters in the present study, considering the data of previous studies as well [3][4][5][6]: (1) the rotational angle as the entire knee exion from the maximum extension to the maximum exion; (2) the rotational angle as the rst half of knee exion from the maximum extension to 90° knee exion; and (3) the rotational angle as the second half of knee exion from 90° knee exion to the maximum exion. Tibial internal rotation relative to the femur was de ned as a positive value.…”

Section: Intraoperative Evaluationmentioning

confidence: 99%

“…Furthermore, Siman et al [5] compared UKA with total knee arthroplasty (TKA) in elderly patients (aged ≥75 years) with isolated medial compartmental arthritis and reported that the postoperative Knee Society Score of UKA was unfortunately equivalent to that of TKA. In contrast, some studies reported that the clinical outcomes of UKA were superior to those of TKA over wide age ranges, including elderly patients [6][7][8]. Therefore, the clinical results after UKA in elderly patients could be inferior to those in nonelderly patients.…”

Section: Introductionmentioning

confidence: 95%

Intraoperative Rotational Kinematics and Its Influence on Postoperative Clinical Outcomes Differ According to Age in Unicompartmental Knee Arthroplasty

Kawaguchi

Inui

Taketomi

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Although Oxford unicompartmental knee arthroplasty (UKA) is used in patients of wide age ranges, there is no clear information regarding the age differences in terms of intraoperative femorotibial rotational kinematics and its influence on clinical outcomes. Therefore, this study was conducted to examine the age differences in terms of postoperative clinical outcomes and intraoperative rotational kinematics and to analyze their relationship with classification according to the age group.Methods: We investigated 111 knees of patients who underwent Oxford UKA using a navigation system and divided them into two groups: elderly (aged ≥75 years; 48 knees) and nonelderly (aged <75 years; 63 knees). Intraoperative tibial internal rotational angles relative to the femur during passive knee flexion were measured using a navigation system, and clinical outcomes were evaluated using knee range of motion, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Knee Society Functional Score at 2 years postoperatively. The relationships between intraoperative tibiofemoral rotational angles and clinical outcomes were also evaluated in the two groups. Results: The intraoperative tibial internal rotational angle relative to the femur during knee flexion was significantly larger in the nonelderly group (13.5°) than in the elderly group (9.0°). The intraoperative tibial internal rotational angle showed a positive correlation with the pain subscale of KOOS only in the nonelderly group. Conclusion: Intraoperative rotational kinematics and its influence on clinical outcomes were different between elderly and nonelderly patients, and the tibial internal rotational angle could be a more important factor for successful UKA in nonelderly patients.

show abstract

“…Recently, there has been a signi cant increase in the number of UKA performed in comparison with total knee arthroplasty (TKA). There are a variety of advantages of UKA, for instance, less blood loss, faster recovery, as well as improved proprioception [1,2]. It has been proven that good to excellent outcomes are found in the mid-term and long-term follow-ups in properly selected patients who underwent UKA [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the implant has a shorter longevity and the revision rate is higher in UKA as compared to TKA [2,4,5]. A variety of factors are responsible for the relatively high failure rate in UKA, for instance, limb malalignment and poor component position after operation [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Superior component position during robotic-assisted Oxford unicompartmental knee arthroplasty (UKA) compared with conventional technique: A 5-year follow-up study

Zhang

Cai

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundThe purpose of our present work was to compare robotic-assisted UKA and conventional UKA regarding the clinical and radiographic results at 5-year follow-up.MethodsForty-one medial UKAs were conducted with robotic assistance (group ROA) between January 2010 and January 2015, and these subjects were matched with 44 subjects undergoing medial UKAs using the same prosthesis, implanted by conventional technique (group CON). In a 5-year follow-up, subjects were clinically evaluated by using Knee Society functional (KSF), Knee Society clinical (KSC), and Knee Society pain (KSP) scores. Radiographic assessments with regards to coronal mechanical axis (CMA) and condylar twist angle (CTA) were compared between group ROA and group CON.ResultsIn the evaluation, the mechanical limb alignment was significantly increased after operation in each group. The implantation accuracy of the coronal mechanical axis was similar in both groups. As for the evaluation of femoral rotation, the internal rotation in group ROA was remarkably less than that in group CON. The difference was not significant in KSP, KSF, KSC scores between group ROA and group CON.ConclusionOur results showed that robotic assistance improves component position without gaining superior CMA or increasing clinical results versus conventional UKA at 5-year follow-up. To conclude, using robotic assistance in UKA is recommended as compared to conventional UKA. Long-term follow-up will be needed to draw conclusion about the overall outcomes of robotic assistance as compared with conventional technique.Trial registrationCurrent Controlled Trials ChiCTR2000033918. Registered 16 June 2020.

show abstract

Unicondylar vs. total knee arthroplasty in medial osteoarthritis: a retrospective analysis of registry data and functional outcome

Cited by 12 publications

References 21 publications

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

Intraoperative Rotational Kinematics and Its Influence on Postoperative Clinical Outcomes Differ According to Age in Unicompartmental Knee Arthroplasty

Superior component position during robotic-assisted Oxford unicompartmental knee arthroplasty (UKA) compared with conventional technique: A 5-year follow-up study

Contact Info

Product

Resources

About