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Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

  • Knee Arthroplasty
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Abstract

Purpose

While the classical indications and contraindications for unicondylar knee arthroplasty (UKA) are widely accepted there is not yet consensus if patients with partial thickness cartilage loss (PTCL) are equally suited for treatment with UKA. The aim of our study was to determine if patients with partial thickness cartilage loss do equally well after treatment with UKA.

Methods

The study retrospectively analyzed the clinical results as well as the survival rates of 64 patients treated with UKA with the medial Oxford knee system. 32 patients had shown PTCL on preoperative radiographs, while the matched control group presented with full thickness cartilage loss (FTCL) medially. Outcome parameters were the Oxford Knee Score (OKS), the American Knee Society Score (AKS), and radiographic analysis.

Results

Postoperative improvement in OKS was 16 (SD 9.0) for patients with PTCL and 17 (SD 8.1) for patients with FTCL. There were no significant differences in the clinical scores between the two groups. Five Patients with PTCL had reoperation whereas there were only two in the bone on bone group. Cumulative survival at 5 years for all revisions was 84 % (95 % CI 72–92 %) for the PTCL group and 97 % (95 % CI 92–100 %) for the FTCL group. This difference was not yet significant (log rank: p = 0.095).

Conclusions

Patients with PTCL are not equally suited for treatment with UKA like patients with bone on bone. Although PTCL has equal clinical results, it was associated with higher revision rates in our series.

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Acknowledgments

This study was supported by the non-commercial research fund of our department.

Conflict of interest

Michael W. Maier, Felix Kuhs, Marcus R. Streit, Peter Schuhmacher, Tilman Walker, Volker Ewerbeck, Tobias Gotterbarm: the authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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Authors and Affiliations

  1. Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany

    Michael W. Maier, Felix Kuhs, Marcus R. Streit, Peter Schuhmacher, Tilman Walker, Volker Ewerbeck & Tobias Gotterbarm

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  1. Michael W. Maier
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  2. Felix Kuhs
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  3. Marcus R. Streit
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  4. Peter Schuhmacher
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  6. Volker Ewerbeck
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  7. Tobias Gotterbarm
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Correspondence to Michael W. Maier.

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Maier, M.W., Kuhs, F., Streit, M.R. et al. Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL. Arch Orthop Trauma Surg 135, 1169–1175 (2015). https://doi.org/10.1007/s00402-015-2236-4

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  • DOI: https://doi.org/10.1007/s00402-015-2236-4

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