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Unicompartmental knee arthroplasty

Christian Scheele, Matthias F Pietschmann, Christian Schröder, Thomas Grupp, Melanie Holderied, Volmar Jansson, Peter E Müller
BACKGROUND: Unicompartmental total knee arthroplasty (UKA) is a well-established treatment option for unicondylar osteoarthritis, and generally leads to better functional results than tricompartimental total knee arthroplasty (TKA). However, revision rates of UKAs are reported as being higher; a major reason for this is aseptic loosening of the tibial component due to implant-cement-bone interface fatigue. The objective of this study was to determine the effects of trabecular bone preparation, prior to implantation of tibial UKAs, on morphological and biomechanical outcomes in a cadaver study...
October 16, 2016: Knee
Hendrik A Zuiderbaan, Jelle P van der List, Laura J Kleeblad, Pauline Appelboom, Nanne P Kort, Andrew D Pearle, Maarten V Rademakers
In this review, we evaluate the modern indications, subjective outcome scores, and survivorship results of unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) in the treatment of isolated medial compartment degeneration of the knee. In addition, in a thorough review of the literature, we evaluate global trends in the use of both methods. In our evaluation of articles, we note that inclusion criteria are relatively broader for UKA than for HTO, where age and body mass index should be considered before HTO surgery in order to optimize clinical outcome and survivorship results...
September 2016: American Journal of Orthopedics
Michael E Berend, John B Meding, Robert A Malinzak, Philip M Faris, Michael D Jackson, Kenneth E Davis, Merrill A Ritter
BACKGROUND: ACL status varies in the arthritic knee during TKA. QUESTIONS/PURPOSES: The purpose of this study was to examine clinical features and intraoperative findings associated with stages of ACL degeneration. METHODS: Coronal deformity, ROM, intra-articular degenerative patterns, and ligament releases were assessed for 1656 knees during TKA. Common patterns of deformity and severity of degenerative change were assessed as a function of the severity of ACL deficiency...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Anna R Gagliardi, Ariel Ducey, Pascale Lehoux, Sue Ross, Patricia Trbovich, Anthony Easty, Chaim Bell, Julie Takata, Christof Pabinger, David R Urbach
INTRODUCTION: Some cardiovascular devices are licensed based on limited evidence, potentially exposing patients to devices that are not safe or effective. Research is needed to ascertain if the same is true of other types of medical devices. Knee arthroplasty is a widely-used surgical procedure yet implant failures are not uncommon. The purpose of this study was to characterize available evidence on the safety and effectiveness of knee implants. METHODS: A review of primary studies included in health technology assessments (HTA) on total (TKA) and unicompartmental knee arthroplasty (UKA) was conducted...
2016: PloS One
L A Lisowski, L I Meijer, M P J van den Bekerom, P Pilot, A E Lisowski
AIMS: The interest in unicompartmental knee arthroplasty (UKA) for medial osteoarthritis has increased rapidly but the long-term follow-up of the Oxford UKAs has yet to be analysed in non-designer centres. We have examined our ten- to 15-year clinical and radiological follow-up data for the Oxford Phase III UKAs. PATIENTS AND METHODS: Between January 1999 and January 2005 a total of 138 consecutive Oxford Phase III arthroplasties were performed by a single surgeon in 129 patients for medial compartment osteoarthritis (71 right and 67 left knees, mean age 72...
October 2016: Bone & Joint Journal
R H Emerson, O Alnachoukati, J Barrington, K Ennin
AIMS: Approved by the Food and Drug Administration in 2004, the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis (AMOA) in patients with an intact anterior cruciate ligament. This unicompartmental knee arthroplasty (UKA) is relatively new in the United States, and therefore long-term American results are lacking. PATIENTS AND METHODS: This is a single surgeon, retrospective study based on prospectively collected data, analysing a consecutive series of primary UKAs using the Phase III mobile-bearing Oxford Knee and Phase III instrumentation...
October 2016: Bone & Joint Journal
Z C Lum, A V Lombardi, J M Hurst, M J Morris, J B Adams, K R Berend
AIMS: Since redesign of the Oxford phase III mobile-bearing unicompartmental knee arthroplasty (UKA) femoral component to a twin-peg design, there has not been a direct comparison to total knee arthroplasty (TKA). Thus, we explored differences between the two cohorts. PATIENTS AND METHODS: A total of 168 patients (201 knees) underwent medial UKA with the Oxford Partial Knee Twin-Peg. These patients were compared with a randomly selected group of 177 patients (189 knees) with primary Vanguard TKA...
October 2016: Bone & Joint Journal
N Bottomley, L D Jones, R Rout, A Alvand, I Rombach, T Evans, W F M Jackson, D J Beard, A J Price
AIMS: The aim of this to study was to compare the previously unreported long-term survival outcome of the Oxford medial unicompartmental knee arthroplasty (UKA) performed by trainee surgeons and consultants. PATIENTS AND METHODS: We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint...
October 2016: Bone & Joint Journal
G G Jones, M Kotti, A V Wiik, R Collins, M J Brevadt, R K Strachan, J P Cobb
AIMS: To compare the gait of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) patients with healthy controls, using a machine-learning approach. PATIENTS AND METHODS: 145 participants (121 healthy controls, 12 patients with cruciate-retaining TKA, and 12 with mobile-bearing medial UKA) were recruited. The TKA and UKA patients were a minimum of 12 months post-operative, and matched for pattern and severity of arthrosis, age, and body mass index...
October 2016: Bone & Joint Journal
S Konan, F S Haddad
AIMS: Medial unicompartmental knee arthroplasty (UKA) is associated with successful outcomes in carefully selected patient cohorts. We hypothesised that severity and location of patellofemoral cartilage lesions significantly influences functional outcome after Oxford medial compartmental knee arthroplasty. PATIENTS AND METHODS: We reviewed 100 consecutive UKAs at minimum eight-year follow-up (96 to 132). A single surgeon performed all procedures. Patients were selected based on clinical and plain radiographic assessment...
October 2016: Bone & Joint Journal
T W Hamilton, H G Pandit, A V Lombardi, J B Adams, C R Oosthuizen, A Clavé, C A F Dodd, K R Berend, D W Murray
AIMS: An evidence-based radiographic Decision Aid for meniscal-bearing unicompartmental knee arthroplasty (UKA) has been developed and this study investigates its performance at an independent centre. PATIENTS AND METHODS: Pre-operative radiographs, including stress views, from a consecutive cohort of 550 knees undergoing arthroplasty (UKA or total knee arthroplasty; TKA) by a single-surgeon were assessed. Suitability for UKA was determined using the Decision Aid, with the assessor blinded to treatment received, and compared with actual treatment received, which was determined by an experienced UKA surgeon based on history, examination, radiographic assessment including stress radiographs, and intra-operative assessment in line with the recommended indications as described in the literature...
October 2016: Bone & Joint Journal
Harshvardhan Chawla, Hassan M Ghomrawi, Jelle P van der List, Ashley A Eggman, Hendrik A Zuiderbaan, Andrew D Pearle
BACKGROUND: Improved survivorship has contributed to the increased use of unicompartmental knee arthroplasty (UKA) as an alternative to total knee arthroplasty (TKA) for unicompartmental knee osteoarthritis. However, heterogeneity among cost-effectiveness analysis studies comparing UKA to TKA has prevented the derivation of discrete implant survivorship targets. The aim of this meta-analysis was to determine the age-stratified annual revision rate (ARR) threshold for UKA to become consistently cost-effective for unicompartmental knee osteoarthritis...
August 28, 2016: Journal of Arthroplasty
Jelle P van der List, Harshvardhan Chawla, Jordan C Villa, Andrew D Pearle
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are both viable treatment options for medial osteoarthritis (OA). However, it remains unclear when to choose for which arthroplasty treatment. Goals of this study were therefore to (1) compare outcomes after both treatments and (2) assess which treatment has superior outcomes in different patient subgroups. METHODS: In this retrospective cohort study, 166 patients received the RESTORIS MCK Medial UKA and 63 patients the Vanguard TKA and were radiographically matched on isolated medial OA...
August 24, 2016: Journal of Arthroplasty
Taotao Xu, Yangjun Lao, Jitao Wang, Fucun Liu, Luwei Xiao, Peijian Tong
BACKGROUND: The purpose of this study was to evaluate the mid-term results of an Oxford phase-3 unicompartmental knee arthroplasty (UKA) for medial arthritis in Chinese patients. METHODS: The study included 64 patients who underwent a minimally invasive Oxford phase-3 UKA for medial knee arthritis. The patients were clinically evaluated preoperatively and at the final follow-up according to the clinical and functional components of the Knee Society Score (KSS), the Hospital for Special Surgery knee score and range of motion...
September 27, 2016: ANZ Journal of Surgery
Norberto Confalonieri, Alessio Biazzo, Pietro Cerveri, Chris Pullen, Alfonso Manzotti
PURPOSE: At the beginning of this century, unprecedented interest in the concept of using less invasive approaches for the treatment of knee degenerative diseases was ignited. Initial interest in this approach was about navigated and non-navigated knee reconstruction using small implants and conventional total knee arthroplasty. METHODS: To this end, a review of the published literature relating to less invasive compartmental arthroplasty of the knee using computer-based alignment techniques and on soft tissue-dedicated small implants is presented...
September 15, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thomas W Hamilton, Rajan Choudhary, Cathy Jenkins, Stephen J Mellon, Christopher A F Dodd, David W Murray, Hemant G Pandit
PURPOSE: Lateral osteophytes have been reported to be associated with lateral compartment disease and as such it is unclear whether medial unicompartmental knee arthroplasty should be performed if these are present. METHODS: Using the OARSI classification system, 0 (no osteophyte) to 3 (large osteophyte), radiographs from a series of cemented meniscal-bearing unicompartmental knee arthroplasty implanted in the setting of full-thickness lateral cartilage where lateral osteophytes were not considered a contraindication were identified and factors associated with the presence and size of lateral osteophytes, and their impact on clinical outcomes and implant survival were assessed...
September 8, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthijs P Somford, Reinoud W Brouwer, Pieter-Stijn W A Haen, Jos J A M van Raay, Tom M van Raaij
BACKGROUND: This study analysed the technical aspects of revision of the Oxford unicompartmental knee arthroplasty (OUKA) and functional results after revision. METHODS: In a historic cohort study we analysed all revised OUKAs that were primarily implanted at our clinic over a 10-year period (1998-2009). The primary aim was to investigate surgical difficulties encountered during revision surgery of the OUKA. Outcomes were the knee society score (KSS), WOMAC (Western Ontario and McMaster Universities), SF-36, VAS pain and VAS satisfaction after revision...
September 10, 2016: Knee
Jelle P van der List, Harshvardhan Chawla, Leo Joskowicz, Andrew D Pearle
Recently, there is a growing interest in surgical variables that are intraoperatively controlled by orthopaedic surgeons, including lower leg alignment, component positioning and soft tissues balancing. Since more tight control over these factors is associated with improved outcomes of unicompartmental knee arthroplasty and total knee arthroplasty (TKA), several computer navigation and robotic-assisted systems have been developed. Although mechanical axis accuracy and component positioning have been shown to improve with computer navigation, no superiority in functional outcomes has yet been shown...
September 6, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jesse E Otero, J Joseph Gholson, Andrew J Pugely, Yubo Gao, Nicholas A Bedard, John J Callaghan
BACKGROUND: Length of hospital stay is a quality metric in joint arthroplasty. Rapid recovery protocols have safely reduced the average length of hospitalization, but it is unclear whether there is a difference in complication and readmission rates between patients discharged the day of surgery or on postoperative day 1 (POD 1). We calculated 30-day complication and readmission after total knee arthroplasty (TKA), total hip arthroplasty (THA), and unicompartmental knee arthroplasty (UKA) based on day of discharge...
August 9, 2016: Journal of Arthroplasty
Panagiota Toliopoulos, Marc-Andre LeBlanc, Jonathan Hutt, Martin Lavigne, Francois Desmeules, Pascal-Andre Vendittoli
OBJECTIVES: The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA. METHODS: Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs...
2016: Open Orthopaedics Journal
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