Wear of congruent meniscal bearings in unicompartmental knee arthroplasty

Psychoyios, V.N.; Crawford, R.W.; O’Connor, John; Murray, David

doi:10.1302/0301-620x.80b6.8176

Cited by 149 publications

(37 citation statements)

References 6 publications

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“…We noted that the patients in whom failure occurred were younger than the group as a whole which gave rise to the suggestion that a mobile device could have helped in the more active young group since these have been shown to have a very low rate of polyethylene wear. 28,29 The recently reported ten-year survivorship of the mobile-bearing Oxford device is 91% 30 in patients under 60 years old, which is comparable with the 11-year survivorship of 92% reported for a fixed-bearing device in a similar young group of patients. 31 The challenge remains to treat this younger group of active patients successfully and reproducibly, but for more elderly patients with unicompartmental disease, our results support the use of a fixed-bearing cemented device.…”

Section: Discussionsupporting

confidence: 58%

Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years

Steele

Hutabarat

Evans

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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There have been several reports of good survivorship and excellent function at ten years with fixed-bearing unicompartmental knee replacement. However, little is known about survival beyond ten years. From the Bristol database of over 4000 knee replacements, we identified 203 St Georg Sled unicompartmental knee replacements (174 patients) which had already survived ten years. The mean age of the patients at surgery was 67.1 years (35.7 to 85) with 67 (38.5%) being under 65 years at the time of surgery. They were reviewed at a mean of 14.8 years (10 to 29.4) from surgery to determine survivorship and function. There were 99 knees followed up for 15 years, 21 for 20 years and four for 25 years. The remainder failed, were withdrawn, or the patient had died. In 58 patients (69 knees) the implant was in situ at the time of death. Revision was undertaken in 16 knees (7.9%) at a mean of 13 years (10.2 to 21.6) after operation. In seven knees (3.4%) this was for progression of arthritis, in three (1.5%) for wear of polyethylene, in four (2%) for tibial loosening, in two (1%) for fracture of the femoral component and in two (1%) for infection. Two knees (1%) were revised for more than one reason. The mean Bristol knee score of the surviving knees fell from 86 (34 to 100) to 79 (42 to 100) during the second decade. Survivorship to 20 years was 85.9% (95% CI 82.9% to 88.9%) and at 25 years was 80% (95% CI 70.2% to 89.8%). Satisfactory survival of a fixed-bearing unicompartmental knee replacement can be achieved into the second decade and beyond.

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Section: Discussionsupporting

confidence: 58%

Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years

Steele

Hutabarat

Evans

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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“…Psychoyios et al [38] state that revision surgery is not always a solution, as in one of every four revisions the problem is not solved. This series suggests that patients with complaints of pain should be investigated, carefully followed up, and revision for unexplained pain must be avoided as it may not be warranted in these cases [23].…”

Section: Discussionmentioning

confidence: 99%

“…The main reasons for its rising popularity are the introduction of minimally invasive surgical (MIS) techniques [31, 41] with modified surgical equipment, the publication of the excellent medium- and long-term results of the Oxford Phase 2 arthroplasty [14, 39, 44, 45] and the well-documented improved polyethylene wear characteristics of the mobile bearing device [18, 38]. Medial osteoarthritis of the knee is considered to be a unicompartmental disease and, when left untreated, it may later progress to involve the other knee compartments [1].…”

Section: Introductionmentioning

confidence: 99%

Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure

Lisowski

Bekerom

Pilot

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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PurposeIn the last decade, a major increase in the use of and interest in unicompartmental knee arthroplasty (UKA) has developed. The Oxford Phase 3 UKA is implanted with a minimally invasive technique using newly developed instruments. The objective of this prospective study was to evaluate the outcome of UKA in patients with medial osteoarthritis of the knee in a high-volume unit.MethodsTwo-hundred and forty-four UKAs were performed with a minimally invasive approach. The median age was 72 (43–91) years. The median follow-up was 4.2 years (range 1–10.4 years). Fourteen patients died, and nine were considered to be lost to follow-up, but all had a well-functioning prosthesis in situ until their last follow-up. Pain, function and health-related quality of life were evaluated pre- and postoperatively using patient- and assessor-based outcome scores, as well as radiographic evidence.ResultsThe mean Knee Society knee and function scores, WOMAC-scores, Oxford-score and VAS pain and satisfaction all improved. Nine knees required revision. Eleven patients required an additional arthroscopic procedure due to persisting pain secondary to intra-articular pathology, and four patients required manipulation under anaesthesia because of limited range of motion. The 7-year cumulative survival rate of the arthroplasty was 94.4%. A low incidence (21%) of a radiolucent line beneath the tibial component was observed at 5 years of follow-up.ConclusionThis study showed a high survival rate of the Oxford Phase 3 UKA. Patient satisfaction and functional performance were also very high. Major complication rate was low; in addition, the incidence of radiolucency under the tibial component, when compared to present literature, was low. When strict indication criteria are followed, excellent, durable, and in our opinion reliable, results can be expected for this procedure.

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“…Revision arthroplasty does not cure pain in every case, and in SKAR 2004 [34] unexplained pain following UKRs was reported to be 5–6 %. Such procedures are often not only unnecessary but also ineffective [23]. In our study, four patients (2.28 %) were revised to TKR at an average of 31.7 months (range 19–54 months) for persistent pain.…”

Section: Discussionmentioning

confidence: 81%

“…Polyethylene wear has often been cited as a cause of failure after UKR, more so in association with flat articulating surfaces than with congruent mobile bearings [19, 21–23]. Berger et al [24] reported no revisions for polyethylene wear in a series of 51 knees that were treated with flat articulating surface (fixed-bearing Miller−Galante).…”

Section: Discussionmentioning

confidence: 99%

Mid-term results of Miller−Galante unicompartmental knee replacement for medial compartment knee osteoarthritis

Venkatesh

Maheswaran

2015

J Orthopaed Traumatol

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BackgroundThe purpose of this study is to analyse and report the mid-term results of 175 unicompartmental knee replacement (UKR) procedures performed for medial compartment knee arthritis from January 2001 to January 2010.Materials and methodsThe cohort participants were selected after stringent inclusion criteria and the average follow-up was 5.6 years (range 2–10 years). The fixed-bearing UKR procedure was carried out on all patients.ResultsThe pre-operative mean knee range of movement improved from 100° ± 11.3° to 118.3° ± 12° (p value <0.001). The pre-operative mean Knee Society (KS) knee and functional score improved from 47 ± 5.5 and 55.1 ± 4.6 to 91.8 ± 9.2 and 92 ± 10.1 (p value <0.001), respectively. The revision rate of the cohort was 4 % (seven knees) and implant survival rate was 96 % at the end of 10 years; 87 % of the cohort were satisfied with the procedure and had a normal gait pattern. In this study, there was no statistical difference between groups with a body mass index (BMI) ≤30 kg/m2 and those with a BMI ≥30 kg/m2, and between groups aged ≤55 years and those aged ≥55 years, in clinical and functional outcome following UKR.ConclusionThis study confirms that fixed-bearing UKR gives excellent results in patients with medial compartment knee arthritis who comply with the inclusion criteria. Age and BMI were not considered to influence the clinical and functional outcomes.Level of evidence-III.

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Wear of congruent meniscal bearings in unicompartmental knee arthroplasty

Cited by 149 publications

References 6 publications

Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years

Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years

Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure

Mid-term results of Miller−Galante unicompartmental knee replacement for medial compartment knee osteoarthritis

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