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Morad Chughtai, John J Kelly, Jared M Newman, Assem A Sultan, Anton Khlopas, Nipun Sodhi, Anil Bhave, Michael C Kolczun, Michael A Mont
This study evaluated the use of telerehabilitation during the postoperative period for patients who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Specifically, this study evaluated the following: (1) patient compliance and adherence to the program, (2) time spent performing physical therapy exercises, (3) the usability of the virtual rehabilitation platform, and (4) clinical outcome scores in a selected primary knee arthroplasty cohort. A total of 157 consecutive patients underwent TKA ( n  = 18) or UKA ( n  = 139)...
March 16, 2018: Journal of Knee Surgery
Stephanie R Filbay, Andrew Judge, Antonella Delmestri, Nigel K Arden
BACKGROUND: One-in-five patients are dissatisfied following knee arthroplasty and <50% have fulfilled expectations. The relationship between knee-arthroplasty expectations and surgical outcome remains unclear. PURPOSE: Are expectations regarding the impact of pain on postoperative life predictive of one-year outcome? Does the impact of pain on preoperative quality of life (QOL) influence this relationship? METHODS: Longitudinal cohort of 1044 uni-compartmental (43%) or total knee-arthroplasty (57%) (UKA or TKA) patients, aged mean 69 ± 9 years...
February 15, 2018: Journal of Arthroplasty
Chloe E H Scott, Matilda F R Powell-Bowns, Deborah J MacDonald, Philip M Simpson, Frazer A Wade
BACKGROUND: The aim of this study is to investigate differences in implant requirement, outcomes, and re-revision when total knee arthroplasty (TKA) was performed following unicompartmental knee arthroplasties (UKAs) with metal-backed (MB) compared to all-polyethylene (AP) tibial components. METHODS: Retrospective study of 60 UKAs converted to 60 TKAs at mean 7.3 years (0.1 to 17) after implantation in 55 patients (mean age, 64 [49-83]; 44% male): 44 MB and 16 AP...
February 12, 2018: Journal of Arthroplasty
Arman Motesharei, Philip Rowe, Mark Blyth, Bryn Jones, Angus Maclean
Robot-assisted unicompartmental knee surgery has been shown to improve the accuracy of implant alignment. However, little research has been conducted to ascertain if this results in a measureable improvement in knee function post operatively and a more normal gait. The kinematics of 70 OA knees were assessed using motion analysis in an RCT (31 receiving robotic-assisted surgery, and 39 receiving traditional manual surgery) and compared to healthy knees. Statistically significant kinematic differences were seen between the two surgical groups from foot-strike to mid-stance...
March 6, 2018: Gait & Posture
Pablo Sanz-Ruiz, Jose Antonio Matas-Diez, Esther Carbo-Laso, Ruben Perez-Mañanes, Javier Vaquero-Martín
The true value of use of patient-specific instrumentation (PSI) systems by inexperienced surgeons during their learning curve to improve the clinical and radiographic outcome of unicompartmental knee arthroplasty (UKA) has not been previously studied. Fifty patients with a mean age of 64.3 years undergoing surgery for Oxford UKA were prospectively divided into two groups. Twenty-five patients were operated on by a surgeon with no prior experience in UKA using a PSI system and the other 25 patients by an experienced surgeon using a conventional procedure...
March 7, 2018: Journal of Knee Surgery
Sim Johal, Naoki Nakano, Mark Baxter, Ihab Hujazi, Hemant Pandit, Vikas Khanduja
Unicompartmental knee arthroplasty (UKA) is a bone conserving and ligament-sparing procedure that reliably restores normal knee kinematics and function for arthritis limited either to the medial or the lateral compartment of the knee. Although there is enough evidence to demonstrate that the UKA offers good medium to long-term success given the correct patient selection, prosthesis design, and implantation technique, there are several reports to suggest inferior survival rates in comparison with the total knee arthroplasty (TKA)...
March 7, 2018: Journal of Knee Surgery
Richard L Purcell, John P Cody, Deborah J Ammeen, Nitin Goyal, Gerard A Engh
INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is an effective alternative to total knee arthroplasty (TKA) for the management of unicondylar osteoarthritis. Historical contraindications limit patients' eligibility for UKA. However, recent reports have suggested that some contraindications may not be absolute. This study evaluates preoperative flexion contracture with regard to UKA. METHODS: This study was a retrospective review of 53 patients with preoperative flexion contracture between 11° and 20° who underwent fixed-bearing UKA and a matched cohort of 53 patients who underwent cruciate-retaining TKA...
February 27, 2018: Journal of the American Academy of Orthopaedic Surgeons
Kyoung-Tak Kang, Oh-Ryong Kwon, Juhyun Son, Dong-Suk Suh, Sae Kwang Kwon, Yong-Gon Koh
In this study, we performed a virtual mobile-bearing unicompartmental knee arthroplasty (UKA) on the contact pressure in the tibial insert and articular cartilage by using finite element (FE) analysis to understand clinical observations and elaborate on the potential risks associated with a joint line preservation such as wear on tibial insert and osteoarthritis on other compartment. Neutral position of the knee joint was defined in 0 mm joint line, and contact pressure between tibial insert and articular cartilage varies with respect to changes of joint line...
February 28, 2018: Australasian Physical & Engineering Sciences in Medicine
Mirco Lo Presti, Giuseppe Gianluca Costa, Sergio Cialdella, Giuseppe Agrò, Alberto Grassi, Silvio Caravelli, Massimiliano Mosca, Giulio Maria Marcheggiani Muccioli, Stefano Zaffagnini
Unicompartmental knee arthroplasty (UKA) has increased in popularity in the last years, also in younger and more active patients with great expectancies. The purpose of our study was to investigate the change in sports activities before and after medial UKA. We surveyed 53 athletic patients; all underwent cemented medial UKA, to determine not only their subjective and objective evaluation of clinical status with Hospital for Special Surgery (HSS) and visual analog score (VAS) score, but also their sporting and recreational activities at a mean follow-up of 48 ± 6 months (range, 18-56 months)...
February 28, 2018: Journal of Knee Surgery
Laura J Kleeblad, Todd A Borus, Thomas M Coon, Jon Dounchis, Joseph T Nguyen, Andrew D Pearle
BACKGROUND: Studies have showed improved accuracy of lower leg alignment, precise component position, and soft-tissue balance with robotic-assisted unicompartmental knee arthroplasty (UKA). No studies, however, have assessed the effect on midterm survivorship. Therefore, the purpose of this prospective, multicenter study was to determine midtem survivorship, modes of failure, and satisfaction of robotic-assisted medial UKA. METHODS: A total of 473 consecutive patients (528 knees) underwent robotic-arm-assisted medial UKA surgery at 4 separate institutions between March 2009 and December 2011...
January 31, 2018: Journal of Arthroplasty
S Miller, A Agarwal, W B Haddon, L Johnston, G Arnold, W Wang, R J Abboud
Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Statistical power was calculated using SPSS. Results No significant difference was found in the spatiotemporal parameters of gait and survival years of the knee prosthesis between the two groups...
February 27, 2018: Annals of the Royal College of Surgeons of England
Georg Matziolis, Tanja Mueller, Frank Layher, Andreas Wagner
PURPOSE: Although the spacer block technique has been recommended for the implantation of unicompartmental knee arthroplasty (UKA), there is still a lack of data concerning the resulting component positioning. METHODS: This retrospective study included 193 consecutive patients who had undergone medial UKA using the spacer technique. On the basis of the postoperative long standing radiographs, the coronal component alignment was determined in relation to the mechanical axes and the sagittal component alignment in relation to the anatomical axes of the tibia and femur...
February 26, 2018: Archives of Orthopaedic and Trauma Surgery
Chun-Hao Huang, E Todd Schroeder, Christopher Powers
Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA...
February 26, 2018: Physiotherapy Theory and Practice
Kye-Youl Cho, Kang-Il Kim, Sang-Jun Song, Kyu-Jin Kim
Purpose: The purpose of this study was to determine the results of mobile bearing unicompartmental knee arthroplasty (UKA) with an intentionally increased flexion angle of the femoral component in patients requiring high flexion. Materials and Methods: We investigated 45 knees treated by UKA. Clinically, we measured the range of motion (ROM) and the American Knee Society (AKS) score preoperatively and at final follow-up and investigated complications. Radiologically, we measured the flexion angle of the femoral component, the posterior slope angle of the tibial component, the femorotibial angle and mechanical axis of the limb postoperatively...
March 1, 2018: Knee Surgery & related Research
Peter L Lewis, David C Davidson, Stephen E Graves, Richard N de Steiger, William Donnelly, Alana Cuthbert
BACKGROUND: Some surgeons contend that unicompartmental knee arthroplasty (UKA) can easily be revised to a TKA when revision is called for, whereas others believe that this can be complex and technically demanding. There has been little research regarding the efficacy or rationale of using metal augmentation and tibial stem extensions when revising a UKA to a TKA. QUESTION/PURPOSES: (1) Is the use of stem extensions for the tibial component associated with increased survival when revising a UKA to a TKA? (2) Is the addition of modular augments associated with increased survival compared with stem extensions alone? (3) Is TKA design (minimally stabilized versus posterior-stabilized) or (4) tibial fixation (cemented versus cementless) associated with differences in survivorship? METHODS: Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were used to analyze implant survival after revision of a UKA to a TKA, comparing results in which tibial components were used with and without modular components...
February 23, 2018: Clinical Orthopaedics and related Research
Chloe E H Scott, Frazer A Wade, Deborah MacDonald, Richard W Nutton
INTRODUCTION: Biomechanical studies have suggested that proximal tibial strain is elevated in UKAs incorporating all-polyethylene tibial components with concern that this leads to premature failure. This study reports minimum 10-year outcomes for a UKA incorporating an all-polyethylene tibial component to determine whether these concerns were realised. MATERIALS AND METHODS: 109 fixed bearing UKAs (97 patients, mean age 68 (range 48-87), 54/97 (56%) female) with all-polyethylene tibial components were followed up for ≥ 10 years with Oxford Knee Scores, Forgotten Joint Scores and Kaplan-Meier analysis...
February 23, 2018: Archives of Orthopaedic and Trauma Surgery
Zhan-Feng Zhang, Ji-Kang Min, Dan Wang, Jian-Ming Zhong, Heng Li
OBJECTIVE: To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA), and analyze its influential factors by comparing with total knee arthroplasty. METHODS: A retrospective study of 130 cases from July 2012 to July 2015 were enrolled, of which and 65 cases were UKA, and 65 cases were TKA. In UKA group there were 27 males and 38 females, and the mean age was (62.3±4.3) years old (ranged, 50 to 82 years old). There were 14 cases older than 70 years old, while 51 cases among 50 to 70 years old...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yong He, Lianbo Xiao, Weitao Zhai, Maximilian F Kasparek, Guilin Ouyang, Friedrich Boettner
Background: Data on indication of Unicompartmental Knee Arthroplasty (UKA) in the Asian population are currently not available. The current paper evaluates patients undergoing knee replacement at a Chinese Orthopaedic Specialty Hospital to report the percentage of patients who meet radiographic and clinical indication criteria for UKA. Methods: Over a one-year period 463 consecutive patients (515 knees) underwent primary knee replacement surgery. Clinical data were recorded and preoperative radiographs were assessed...
2018: Open Orthopaedics Journal
Myung-Ku Kim, Jung-Ro Yoon, Se-Hyun Yang, Young-Soo Shin
PURPOSE: Gait analysis is a valuable instrument for measuring function objectively after unicompartmental knee arthroplasty (UKA). However, most gait analysis studies have reported conflicting results for functional assessment after UKA. This meta-analysis compared the gait patterns of UKA patients and healthy controls during level walking. METHODS: Studies were included in the meta-analysis if they recorded vertical ground reaction force (GRF), flexion at initial contact, flexion at loading response, extension at mid-stance, flexion at swing, walking speed, cadence, and stride length in UKA patients or healthy controls...
February 15, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kyung-Han Ro, Jae-Won Heo, Dae-Hee Lee
BACKGROUND: Implant survivorship is reported to be lower and complications, particularly bearing dislocation, are reported to be more frequent in Asian than in Western patients with medial knee osteoarthritis (OA) undergoing Oxford Phase III unicompartmental knee arthroplasty (UKA). To date, however, these complications have not been compared between these groups of patients. QUESTIONS/PURPOSES: The purpose of this study was to perform a meta-analysis comparing the standardized incidence rates of (1) all-cause reoperation; (2) reoperation related to bearing dislocation; and (3) reoperation related to progression of lateral compartment arthritis in Asian and Western patients with medial knee OA who underwent Oxford Phase III UKA...
February 2, 2018: Clinical Orthopaedics and related Research
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