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Clinical and functional results after the rehabilitation period in minimally-invasive unicondylar knee arthroplasty patients

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The objective of the present study was to analyze the clinical and functional outcome after minimally-invasive implantation of a Repicci-type unicompartmental sledge prosthesis . In 29 patients with primary unicompartmental knee osteoarthritis, 29 replacements of the medial compartment and four of the lateral compartment were performed using the minimally-invasive technique with the metal-backed and the all-polyethylene versions of the Repicci sledge prosthesis. Electromyography (EMG) of standardized locations was measured with the MyoSystem 2000 and analyzed with Myoresearch software. Gait analysis was performed with a six-camera motion analysis system and force platforms. Established clinical and quality of life (SF-36) scores were used to compare patients with 11 healthy age-matched individuals. The Repicci sledge prosthesis led postoperatively to functional results that were in the range of healthy joints, and superior to sledge prostheses of a different design. Gait and balance parameters were comparable to the control group, whilst electromyographically lower amplitudes were found in the patients than the controls and in the operated legs as compared to the non-operated legs. Many parameters of quality of life and activity were comparable to age-matched healthy individuals, and quality of life was superior to total knee replacement. When implanted using a minimally-invasive technique and with suitable patient selection, the Repicci sledge led to functional results comparable to those of healthy joints and gait parameters comparable to those of healthy individuals. The level of evidence is Level III, retrospective cohort study.

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References

  1. Aarons H, Hall G, Hughes S, Salmon P (1996) Short-term recovery from hip and knee arthroplasty. J Bone Joint Surg Br 78:555–558

    CAS  PubMed  Google Scholar 

  2. Arslanian C, Bond M (1999) Computer assisted outcomes research in orthopedics: total joint replacement. J Med Syst 23:239–247

    Article  CAS  PubMed  Google Scholar 

  3. Barrett WP, Scott RD (1987) Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Joint Surg Am 69:1328–1335

    CAS  PubMed  Google Scholar 

  4. Bullinger M (1995) German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International quality of life assessment. Soc Sci Med 41:1359–1366

    CAS  PubMed  Google Scholar 

  5. Chiu HC, Mau LW, Hsu YC, Chang JK (2001) Postoperative 6-month and 1-year evaluation of health-related quality of life in total hip replacement patients. J Formos Med Assoc 100:461–465

    CAS  PubMed  Google Scholar 

  6. Costigan PA, Deluzio KJ, Wyss UP (2002) Knee and hip kinetics during normal stair climbing. Gait Posture 16:31–37

    Article  PubMed  Google Scholar 

  7. Deshmukh RV, Scott RD (2001) Unicompartmental knee arthroplasty: long-term results. Clin Orthop 392:272–278

    PubMed  Google Scholar 

  8. Engh GA (2002) Orthopaedic crossfire—can we justify unicondylar arthroplasty as a temporizing procedure? in the affirmative. J Arthroplasty 17:54–55

    Google Scholar 

  9. Fuchs S, Frisse D, Tibesku CO, Laass H, Rosenbaum D (2002) Proprioceptive function, clinical results, and quality of life after unicondylar sledge prostheses. Am J Phys Med Rehabil 81:478–482

    Article  CAS  PubMed  Google Scholar 

  10. Fuchs S, Genkinger M, Laass H, Rosenbaum D (2001) Results of bicondylar sledge prostheses with special reference to the gait pattern. Biomed Tech (Berl) 46:142–146

    CAS  Google Scholar 

  11. Hilding MB, Backbro B, Ryd L (1997) Quality of life after knee arthroplasty. A randomized study of 3 designs in 42 patients, compared after 4 years. Acta Orthop Scand 68:156–160

    CAS  PubMed  Google Scholar 

  12. Huskisson EC (1982) Measurement of pain. J Rheumatol 9:768–769

    PubMed  Google Scholar 

  13. Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 58:754–765

    CAS  PubMed  Google Scholar 

  14. Jerosch J, Floren M (2000) Quality of life improvement (SF-36) after implantation of a knee endoprosthesis. Unfallchirurg 103:371–374

    CAS  PubMed  Google Scholar 

  15. Jones CA, Voaklander DC, Johnston DW, Suarez-Almazor ME (2000) Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. J Rheumatol 27:1745–1752

    CAS  PubMed  Google Scholar 

  16. Kageyama Y, Miyamoto S, Ozeki T, Hiyoshi M, Kushida K, Inoue T (1998) Outcomes for patients undergoing one or more total hip and knee arthroplasties. Clin Rheumatol 17:130–134

    CAS  PubMed  Google Scholar 

  17. Kiebzak GM, Campbell M, Mauerhan DR (2002) The SF-36 general health status survey documents the burden of osteoarthritis and the benefits of total joint arthroplasty: but why should we use it? Am J Manag Care 8:463–474

    PubMed  Google Scholar 

  18. Kolstad K, Wigren A, Oberg K (1982) Gait analysis with an angle diagram technique: application in healthy persons and in studies of Marmor knee arthroplasties. Acta Orthop Scand 53:733–743

    CAS  PubMed  Google Scholar 

  19. Koralewicz LM, Engh GA (2000) Comparison of proprioception in arthritic and age-matched normal knees. J Bone Joint Surg Am 82:1582–1588

    Google Scholar 

  20. Lee TH, Tsuchida T, Kitahara H, Moriya H (1999) Gait analysis before and after unilateral total knee arthroplasty. Study using a linear regression model of normal controls—women without arthropathy. J Orthop Sci 4:13–21

    Article  CAS  PubMed  Google Scholar 

  21. Lewold S, Robertsson O, Knutson K, Lidgren L (1998) Revision of unicompartmental knee arthroplasty: outcome in 1,135 cases from the Swedish knee arthroplasty study. Acta Orthop Scand 69:469–474

    CAS  PubMed  Google Scholar 

  22. Mainard D, Guillemin F, Cuny C, Mejat-Adler E, Galois L, Delagoutte J (2000) Quality of life assessment one year after total hip or knee arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 86:464–473

    CAS  PubMed  Google Scholar 

  23. March LM, Cross MJ, Lapsley H et al (1999) Outcomes after hip or knee replacement surgery for osteoarthritis. A prospective cohort study comparing patients‘ quality of life before and after surgery with age-related population norms. Med J Aust 171:235–238

    CAS  PubMed  Google Scholar 

  24. Mattsson E, Olsson E, Brostrom LA (1990) Assessment of walking before and after unicompartmental knee arthroplasty. A comparison of different methods. Scand J Rehabil Med 22:45–50

    CAS  PubMed  Google Scholar 

  25. McGuigan FX, Hozack WJ, Moriarty L, Eng K, Rothman RH (1995) Predicting quality-of-life outcomes following total joint arthroplasty. Limitations of the SF-36 health status questionnaire. J Arthroplasty 10:742–747

    CAS  PubMed  Google Scholar 

  26. Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 80:983–989

    CAS  PubMed  Google Scholar 

  27. O’Connell T, Browne C, Corcoran R, Howell F (2000) Quality of life following total hip replacement. Ir Med J 93:108–110

    CAS  PubMed  Google Scholar 

  28. Pai YC, Rymer WZ, Chang RW, Sharma L (1997) Effect of age and osteoarthritis on knee proprioception. Arthritis Rheum 40:2260–2265

    CAS  PubMed  Google Scholar 

  29. Ranawat CS, Shine JJ (1973) Duo-condylar total knee arthroplasty. Clin Orthop 94:185–195

    CAS  PubMed  Google Scholar 

  30. Repicci JA, Eberle RW (1999) Minimally invasive surgical technique for unicondylar knee arthroplasty. J South Orthop Assoc 8:20–27

    CAS  PubMed  Google Scholar 

  31. Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15:17–22

    PubMed  Google Scholar 

  32. Sculco TP (2002) Orthopaedic crossfire—can we justify unicondylar arthroplasty as a temporizing procedure? in opposition. J Arthroplasty 17:56–58

    Google Scholar 

  33. Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC (1999) Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop 369:61–72

    Article  Google Scholar 

  34. Steiner ME, Simon SR, Pisciotta JC (1989) Early changes in gait and maximum knee torque following knee arthroplasty. Clin Orthop 238:174–182

    PubMed  Google Scholar 

  35. Stockelman RE, Pohl KP (1991) The long-term efficacy of unicompartmental arthroplasty of the knee. Clin Orthop 271:88–95

    PubMed  Google Scholar 

  36. Svard UC, Price AJ (2001) Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br 83:191–194

    Article  CAS  PubMed  Google Scholar 

  37. Swank M, Stulberg SD, Jiganti J, Machairas S (1993) The natural history of unicompartmental arthroplasty. An eight-year follow-up study with survivorship analysis. Clin Orthop 286:130–142

    PubMed  Google Scholar 

  38. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43–49

    PubMed  Google Scholar 

  39. Weiler HT, Pap G, Awiszus F (2000) The role of joint afferents in sensory processing in osteoarthritic knees. Rheumatology (Oxford) 39:850–856

    Article  CAS  Google Scholar 

  40. Whittle MW, Jefferson RJ (1989) Functional biomechanical assessment of the Oxford Meniscal Knee. J Arthroplasty 4:231–243

    Google Scholar 

  41. Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13:890–895

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, University Hospital Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster, Germany

    Susanne Fuchs, Bernd Rolauffs, Thorsten Plaumann, Carsten O. Tibesku & Dieter Rosenbaum

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  1. Susanne Fuchs
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  2. Bernd Rolauffs
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  3. Thorsten Plaumann
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  4. Carsten O. Tibesku
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  5. Dieter Rosenbaum
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Correspondence to Susanne Fuchs.

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Fuchs, S., Rolauffs, B., Plaumann, T. et al. Clinical and functional results after the rehabilitation period in minimally-invasive unicondylar knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 13, 179–186 (2005). https://doi.org/10.1007/s00167-004-0517-5

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  • DOI: https://doi.org/10.1007/s00167-004-0517-5

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