Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Hamilton, Thomas W.; Pandit, Hemant; Inabathula, Avinash; Ostlere, S; Jenkins, C.; Mellon, Stephen; Dodd, Caf; Murray, D.W.

doi:10.1302/0301-620x.99b4.bjj-2016-1061.r1

Cited by 67 publications

(70 citation statements)

References 26 publications

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“…Of those undergoing a PKA, 205 underwent medial, 49 lateral, and 4 patellofemoral arthroplasties. The mean follow-up after the index procedure was 20 months (range [19][20][21][22][23][24]. None of the patients were lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

The Knee Osteoarthritis Grading System for Arthroplasty

Oosthuizen

Takahashi

Rogan³

et al. 2019

The Journal of Arthroplasty

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Background: The aim of this study is to validate the Knee Osteoarthritis Grading System (KOGS) of progressive osteoarthritic degeneration for the tri-compartmental knee. This system defines the site and severity of osteoarthritis to determine a specific knee arthroplasty. Methods: The radiographic sequence for KOGS includes standing coronal (anteroposterior), lateral, 30 skyline patella, 15 and 45 Rosenberg and stress views in 20 of flexion. Cohen's kappa and related agreement statistical methods were used to assess the level of concordance of the 7 evaluators between A and B cohorts for each evaluator and also against the actual arthroplasty used. Sensitivity and specificity was also assessed for the KOGS in identifying true partial knee arthroplasties (PKAs) and total knee arthroplasties (TKAs) as decided from the cohort A evaluations. Results: From a cohort of 330 patients who were included in the study, 71 (22.5%) underwent a TKA procedure, 258 (78.2%) a PKA, and 1 (0.3%) was neither a TKA nor PKA. KOGS was able to identify true PKAs (sensitivity) in the range of 92.2%-98.5% across all the different evaluators. The KOGS method was able to identify a PKA or a TKA with an accuracy ranging from 92% to 98.8% across all different evaluators. The surgical results after 20 months are at least comparable with the expected average in the academic literature. Conclusion: The KOGS classification provides a reliable and accurate tool to assess suitability of an individual patient for undergoing PKA or TKA.

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Section: Resultsmentioning

confidence: 99%

The Knee Osteoarthritis Grading System for Arthroplasty

Oosthuizen

Takahashi

Rogan³

et al. 2019

The Journal of Arthroplasty

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“…In a systematic review published in 2017 by Hamilton et al, the authors stated that to achieve optimal results, surgeons, whether high or low caseload, should follow the advised indications such that ⩾ 20%, or ideally > 30% of their knee arthroplasties are UKA. 56 If they take this into account, then they can anticipate outcomes comparable to those of the long-term series, all of which had high usage (> 20%) and an average 10-year implant survival of 94%.…”

Section: Outcomes Of Ukamentioning

confidence: 98%

Unicompartmental knee arthroplasty

Rodríguez-Merchán¹,

Gómez-Cardero²

2018

EFORT Open Reviews

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An age younger than 60 years, a body weight of 180 lb (82 kg) or more, performing heavy work, having chondrocalcinosis and having exposed bone in the patellofemoral (PF) joint are not contraindications for unicompartmental knee arthroplasty (UKA).Severe wear of the lateral facet of the PF joint with bone loss and grooving is a contraindication for UKA.Medial UKA should only be performed in cases of severe osteoarthritis (OA) as shown in pre-operative X-rays, with medial bone-on-bone contact and a medial/lateral ratio of < 20%.The post-operative results of UKA are generally good. Medium-term and long-term studies have reported acceptable results at 10 years, with implant survival greater than 95% for UKAs performed for medial OA or osteonecrosis and for lateral UKA, especially when fixed-bearing implants are used.When all implant-related re-operations are considered, the 10-year survival rate is 94%, and the 15-year survival rate is 91%.Aseptic loosening is the principal failure mechanism in the first few years in mobile-bearing implants, whereas OA progression causes most failures in later years in fixed-bearing implants.The overall complication rate and the comprehensive re-operation rate are comparable in both mobile bearings and fixed bearings.The survival likelihood of the all-polyethylene UKA implant is similar to that of metal-backed modular designs for UKA.Notable cost savings of approximately 50% can be achieved with an outpatient UKA surgery protocol. Outpatient surgery for UKA is efficacious and safe, with satisfactory clinical results thus far.Cite this article: EFORT Open Rev 2018;3:363-373. DOI: 10.1302/2058-5241.3.170048

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“…AKS-knee scores and AKS-function scores were assessed by two studies in groups of patients who underwent UKA with PTCL and FTCL, at a mean follow-up of > 3.9 years [15,17]. The pooled mean difference in AKS-knee scores was − 2.90 (95%CI − 9.14 to − 3.34; P = 0.36; I 2 = 67%, Fig.…”

Section: Aksmentioning

confidence: 99%

Clinical Outcomes of Unicompartmental Knee Arthroplasty in Patients with Full- Versus Partial-Thickness Cartilage Loss: A Systematic Review and Meta-Analysis

Yan

Wang

et al. 2020

Preprint

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Bakground This meta-analysis was designed to compare postoperative patient-reported outcomes and reoperation rates following unicompartmental knee arthroplasty (UKA) between patients with full-thickness cartilage loss (FTCL) and partial-thickness cartilage loss (PTCL).Methods Multiple databases, including PubMed, Embase, Cochrane Library, and CNKI, were searched to identify studies comparing the Oxford Knee Score (OKS), American Knee Society (AKS) score, and reoperation rates between patients with FTCL and PTCL following UKA. Mean differences were calculated for continuous outcomes, and odds ratios were calculated for binary outcomes.Results A total of 613 UKAs (233 PTCL and 380 FTCL) from five retrospective cohort studies were included. Three studies compared OKSs after ≥2 years of follow-up. The mean difference in postoperative OKSs was significantly higher by 2.92 in the FTCL patients than in the PTCL patients (95% confidence interval [CI] −5.29 to −0.55; P = 0.02). The improvement in the OKS was significantly higher by 2.69 in the FTCL patients than in the PTCL patients (95 % CI −4.79 to −0.60; P = 0.01). AKS-knee and AKS-function scores were assessed in two studies at a mean follow-up time of >3.9 years. The mean difference in AKS-knee scores was similar between the groups (95%CI −9.14 to −3.34; P = 0.36), whereas the pooled mean difference in AKS-function scores was 5.63 higher in the FTCL group (95%CI −9.27 to −1.98; P = 0.002). All studies presented data on reoperation rates and showed that they were statistically higher in patients who underwent UKA with PTCL (OR 2.24, 95%CI 1.15–4.38, P = 0.02).Conclusions Compared with PTCL, FTCL achieved superior postoperative patient-reported outcomes and lower reoperation rates following UKA.

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Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Cited by 67 publications

References 26 publications

The Knee Osteoarthritis Grading System for Arthroplasty

The Knee Osteoarthritis Grading System for Arthroplasty

Unicompartmental knee arthroplasty

Clinical Outcomes of Unicompartmental Knee Arthroplasty in Patients with Full- Versus Partial-Thickness Cartilage Loss: A Systematic Review and Meta-Analysis

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