scholarly journals Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry

2020 ◽  
Vol 91 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Anders El-Galaly ◽  
Poul T Nielsen ◽  
Andreas Kappel ◽  
Steen L Jensen
Keyword(s):  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Propensity Score ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Osteotomy ◽  
Unicompartmental Knee ◽  
Arthroplasty Registry ◽  
Total Knee

Similar Outcome, but Different Surgical Requirement in Conversion Total Knee Arthroplasty following High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Meta-Analysis

2018 ◽  
Vol 32 (07) ◽  
pp. 686-700 ◽  
Author(s):  
Yong Seuk Lee ◽  
Hyun Jung Kim ◽  
Su Jung Mok ◽  
O-Sung Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Quality Data ◽  
Tibial Osteotomy ◽  
Unicompartmental Knee ◽  
Surgical Data ◽  
Total Knee

AbstractThe present systematic review and meta-analysis were conducted to find out how effective any subsequent conversion total knee arthroplasty (TKA) would be after unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) and which is better in outcomes. A rigorous and systematic approach was used. Each of the selected studies was evaluated for methodological quality. Data were extracted by the following standardized protocol: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, kind of index surgery, type of index surgery, average time to failure, mode of failure, surgical data, preclinical score, post-clinical score, and major related complications. Nineteen articles were included in the final analysis. In conversion TKA following UKA, revision components (metal augment, bone graft, and stem) were frequently used, and thicker polyethylene was used comparing to the primary TKA. In the conversion TKA following HTO, only stem was more common (relative risk of revision component UKA:HTO = 0.57:0.07). The estimated range of motions (ROM) of conversion TKA following HTO and UKA was 107.75° (101.93–113.58°) and 111.84° (108.41–115.26°), respectively (p > 0.05). The knee scores of conversion TKA following HTO and UKA were 89.10 (86.45, 91.75) and 85.48 (79.82, 91.14), respectively (p > 0.05). The function scores were 78.60 (72.44, 84.76) and 75.60 (69.85, 81.35), respectively (p > 0.05). Clinical outcome was similar between conversion TKA following HTO and UKA. However, conversion TKA after UKA required more revision components and thicker polyethylene, while conversion TKA after HTO sometimes required a stem to bypass the osteotomy gap.

Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim Mostafa El-Ganzoury ◽  
Zeiad Mohamed Zakaria ◽  
Ahmed Elsayed ◽  
Abd Ellah Elwarwary
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Total Knee

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

scholarly journals High usage of medial unicompartmental knee arthroplasty negatively influences total knee arthroplasty revision rate

2021 ◽  
Author(s):  
Antonio Klasan ◽  
Mei Lin Tay ◽  
Chris Frampton ◽  
Simon William Young
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Revision Rate ◽  
Oxford Knee Score ◽  
High Volume ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Total Knee

Abstract Purpose Surgeons with higher medial unicompartmental knee arthroplasty (UKA) usage have lower UKA revision rates. However, an increase in UKA usage may cause a decrease of total knee arthroplasty (TKA) usage. The purpose of this study was to investigate the influence of UKA usage on revision rates and patient-reported outcomes (PROMs) of UKA, TKA, and combined UKA + TKA results. Methods Using the New Zealand Registry Database, surgeons were divided into six groups based on their medial UKA usage: < 1%, 1–5%, 5–10%, 10–20%, 20–30% and > 30%. A comparison of UKA, TKA and UKA + TKA revision rates and PROMs using the Oxford Knee Score (OKS) was performed. Results A total of 91,895 knee arthroplasties were identified, of which 8,271 were UKA (9.0%). Surgeons with higher UKA usage had lower UKA revision rates, but higher TKA revision rates. The lowest TKA and combined UKA + TKA revision rates were observed for surgeons performing 1–5% UKA, compared to the highest TKA and UKA + TKA revision rates which were seen for surgeons using > 30% UKA (p < 0.001 TKA; p < 0.001 UKA + TKA). No clinically important differences in UKA + TKA OKS scores were seen between UKA usage groups at 6 months, 5 years, or 10 years. Conclusion Surgeons with higher medial UKA usage have lower UKA revision rates; however, this comes at the cost of a higher combined UKA + TKA revision rate that is proportionate to the UKA usage. There was no difference in TKA + UKA OKS scores between UKA usage groups. A small increase in TKA revision rate was observed for high-volume UKA users (> 30%), when compared to other UKA usage clusters. A significant decrease in UKA revision rate observed in high-volume UKA surgeons offsets the slight increase in TKA revision rate, suggesting that UKA should be performed by specialist UKA surgeons. Level of evidence III, Retrospective therapeutic study.

Sign in / Sign up

Export Citation Format

Share Document