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No difference in functional outcomes, quality of life and survivorship between metal-backed and all-polyethylene tibial components in unicompartmental knee arthroplasty: a 10-year follow-up study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to compare functional outcomes, quality of life and survivorship at a minimum of 10 years postoperatively, between MB and AP tibial components in fixed-bearing UKAs.

Methods

A retrospective cohort study of 146 Query ID="Q3" Text="Author names: Please confirm if the author names are presented accurately and in the correct sequence (Lo Ngai Nung, Yeo Seng Jin). Also, kindly confirm the details in the metadata are correct." UKAs performed between 2004 and 2007 by a single fellowship-trained arthroplasty surgeon was carried out. 27 UKAs received MB tibial components and 119 UKAs received AP tibial components. The cohort was followed up prospectively for 10 years. Functional outcomes were compared using the Knee Society Functional Score (KSFS), Knee Society Knee Score (KSKS) and Oxford Knee Score (OKS). Quality of life measures were obtained from the Physical Component Summary (PCS) and Mental Component Summary (MCS), derived from the Short Form 36 Health Survey (SF-36). Propensity score matching was performed in a 1:3 ratio of MB versus AP tibial components to account for possible confounding variables. Thereafter, outcomes between the two groups were compared. The proportion of patients who had attained the minimum clinically important difference (MCID) for the abovementioned scores was recorded as well.

Results

After propensity score matching, there were 28 UKAs with MB tibial components and 76 UKAs with AP tibial components. There was no significant difference between the two groups in functional outcomes (KSFS, KSKS and OKS), quality of life (PCS and MCS) and survivorship (92.3% vs 91.1%, respectively) at a minimum of 10 years postoperatively. However, a significantly higher proportion of patients in the group with AP tibial components attained the MCID for PCS at 10 years postoperatively, compared to those with MB tibial components (p = 0.031).

Conclusion

In conclusion, there were no significant differences in functional outcomes measures, quality of life and survivorship between MP and AP tibial components at a minimum of 10 years postoperatively.

Level of evidence

III.

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References

  1. Bruni D, Gagliardi M, Akkawi I, Raspugli GF, Bignozzi S, Marko T, Bragonzoni L, Grassi A, Marcacci M (2016) Good survivorship of all-polyethylene tibial component UKA at long-term follow-up. Knee Surg Sports Traumatol Arthrosc 24:182–187

    Article  Google Scholar 

  2. Clement ND, Bell A, Simpson P, Macpherson G, Patton JT, Hamilton DF (2020) Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis. Bone Joint Res 9:15–22

    Article  CAS  Google Scholar 

  3. Clement ND, MacDonald D, Simpson AHRW (2014) The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22:1933–1939

    Article  CAS  Google Scholar 

  4. Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I (2007) Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthritis Cartil 15:273–280

    Article  CAS  Google Scholar 

  5. Farivar SS, Cunningham WE, Hays RD (2007) Correlated physical and mental health summary scores for the SF-36 and SF-12 Health Survey, vol 1. Health Qual Life Outcomes 5:3–10

    Article  Google Scholar 

  6. Hutt JRB, Farhadnia P, Massé V, Lavigne M, Vendittoli PA (2015) A randomised trial of all-polyethylene and metal-backed tibial components in unicompartmental arthroplasty of the knee. Bone Joint J 97-B:786–792

    Article  CAS  Google Scholar 

  7. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop. https://doi.org/10.1097/00003086-198911000-00004

    Article  PubMed  Google Scholar 

  8. Koh IJ, Suhl KH, Kim MW, Kim MS, Choi KY, In Y (2017) Use of all-polyethylene tibial components in unicompartmental knee arthroplasty increases the risk of early failure. J Knee Surg 30:807–815

    Article  Google Scholar 

  9. Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71:145–150

    Article  CAS  Google Scholar 

  10. Laucis NC, Hays RD, Bhattacharyya T (2015) Scoring the SF-36 in orthopaedics: a brief guide. J Bone Joint Surg Am 97:1628–1634

    Article  Google Scholar 

  11. Lee M, Chen J, Shi LuC, Lo NN, Yeo SJ (2019) No differences in outcomes scores or survivorship of unicompartmental knee arthroplasty between patients younger or older than 55 years of age at minimum 10-year followup. Clin Orthop 477:1434–1446

    Article  Google Scholar 

  12. Lee M, Huang Y, Chong HC, Ning Y, Lo NN, Yeo SJ (2016) Predicting satisfaction for unicompartmental knee arthroplasty patients in an Asian population. J Arthroplasty 31:1706–1710

    Article  Google Scholar 

  13. Lee WC, Kwan YH, Chong HC, Yeo SJ (2017) The minimal clinically important difference for Knee Society Clinical Rating System after total knee arthroplasty for primary osteoarthritis. Knee Surg Sports Traumatol Arthrosc 25:3354–3359

    Article  Google Scholar 

  14. Lombardi AV, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA (2009) Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop 467:1450–1457

    Article  Google Scholar 

  15. Lustig S, Paillot JL, Servien E, Henry J, Ait Si Selmi T, Neyret P (2009) Cemented all polyethylene tibial insert unicompartimental knee arthroplasty: a long term follow-up study. Orthop Traumatol Surg Res 95:12–21

    Article  CAS  Google Scholar 

  16. Mariani EM, Bourne MH, Jackson RT, Jackson ST, Jones P (2007) Early failure of unicompartmental knee arthroplasty. J Arthroplasty 22:81–84

    Article  Google Scholar 

  17. Naal FD, Fischer M, Preuss A, Goldhahn J, von Knoch F, Preiss S, Munzinger U, Drobny T (2007) Return to sports and recreational activity after unicompartmental knee arthroplasty. Am J Sports Med 35:1688–1695

    Article  Google Scholar 

  18. Nouta KA, Verra WC, Pijls BG, Schoones JW, Nelissen RGHH (2012) All-polyethylene tibial components are equal to metal-backed components: systematic review and meta-regression. Clin Orthop 470:3549–3559

    Article  Google Scholar 

  19. Scott CEH, Eaton MJ, Nutton RW, Wade FA, Evans SL, Pankaj P (2017) Metal-backed versus all-polyethylene unicompartmental knee arthroplasty: Proximal tibial strain in an experimentally validated finite element model. Bone Joint Res 6:22–30

    Article  CAS  Google Scholar 

  20. Scott CEH, Eaton MJ, Nutton RW, Wade FA, Pankaj P, Evans SL (2013) Proximal tibial strain in medial unicompartmental knee replacements: A biomechanical study of implant design. Bone Joint J 95 B:1339–1347

    Article  Google Scholar 

  21. Small SR, Berend ME, Ritter MA, Buckley CA, Rogge RD (2011) Metal backing significantly decreases tibial strains in a medial unicompartmental knee arthroplasty model. J Arthroplasty 26:777–782

    Article  Google Scholar 

  22. Vasso M, Corona K, D’Apolito R, Mazzitelli G, Panni AS (2017) Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty. Joints 5:44–50

    Article  Google Scholar 

  23. Xu S, Lim W-AJ, Chen JY, Lo NN, Chia S-L, Tay DKJ, Hao Y, Yeo SJ (2019) The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty. Bone Joint J 101-B:213–220

    Article  CAS  Google Scholar 

  24. Zambianchi F, Digennaro V, Giorgini A, Grandi G, Fiacchi F, Mugnai R, Catani F (2015) Surgeon’s experience influences UKA survivorship: a comparative study between all-poly and metal back designs. Knee Surg Sports Traumatol Arthrosc 23:2074–2080

    Article  CAS  Google Scholar 

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Funding

This study was supported by funding by Singhealth-Duke NUS (13/FY2017/P1/16-A30).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore

    Merrill Lee, Daryl Cheng, Jerry Chen, Lincoln Liow, Ngai Nung Lo & Seng Jin Yeo

  2. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Jerry Chen

Authors
  1. Merrill Lee
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  2. Daryl Cheng
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  3. Jerry Chen
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  4. Lincoln Liow
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  5. Ngai Nung Lo
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  6. Seng Jin Yeo
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Corresponding author

Correspondence to Merrill Lee.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee.

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Lee, M., Cheng, D., Chen, J. et al. No difference in functional outcomes, quality of life and survivorship between metal-backed and all-polyethylene tibial components in unicompartmental knee arthroplasty: a 10-year follow-up study. Knee Surg Sports Traumatol Arthrosc 29, 3368–3374 (2021). https://doi.org/10.1007/s00167-020-06247-3

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  • DOI: https://doi.org/10.1007/s00167-020-06247-3

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