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Roentgen stereophotogrammetric analysis: an effective tool to predict implant survival after an all-poly unicompartmental knee arthroplasty—a 10 year follow-up study

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

Abstract

Purpose

The main purpose of the present study was to determine long-term implant fixation of 15 unicompartmental knee arthroplasty (UKAs) with an all-poly tibial component using Roentgen stereophotogrammetric analysis (RSA) at a mean 10-year follow-up. The secondary purpose was to investigate whether the progressive loss of implant’s fixation correlates with a reduction in Knee society score (KSS).

Methods

Fifteen non-consecutive patients with primary knee osteoarthritis received a UKA with an all-poly tibial component were assessed using KSS scores pre-operatively and post-operatively and RSA on day 2 after surgery, then at 3, 6, and 12 months and yearly thereafter. The mean last follow-up was 10 years.

Results

An increase in maximum total point motion (MTPM) values from 6 months to 1 year post-operatively was found respect to post-operative reference. Implants’ displacement values were always <2 mm during the first 6 months, and then, two different trends were noticed in revised and non-revised implants. MTPM increase between 1 and 2 years of follow-up in non-revised UKAs was always <0.2 mm, whereas it was >0.2 mm in revised UKAs. A linear and negative correlation with statistical significance was found between MTPM and both clinical and functional KSS scores (p < 0.001).

Conclusion

Also in a long-term follow-up evaluation, RSA is an effective tool to predict functional results after an all-poly UKA providing also a relevant predictive value at 1 year follow-up, and this can be very useful for both patients and surgeons.

Level of evidence

Diagnostic studies, Level III.

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References

  1. Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72

    Google Scholar 

  2. Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty 23:159–163

    Article  PubMed  Google Scholar 

  3. Bhattacharya R, Scott CE, Morris HE, Wade F, Nutton RW (2011) Survivorship and patient satisfaction of a fixed bearing unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component. Knee 19(4):348–351

    Article  PubMed  Google Scholar 

  4. Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16(1):9–18

    PubMed  Google Scholar 

  5. Bruni D, Iacono F, Raspugli G, Zaffagnini S, Marcacci M (2012) Is unicompartmental arthroplasty an acceptable option for spontaneous osteonecrosis of the knee? Clin Orthop Relat Res 470:1442–1451

    Article  PubMed Central  PubMed  Google Scholar 

  6. Bruni D, Iacono F, Russo A, Zaffagnini S, Marcheggiani Muccioli GM, Bignozzi S, Bragonzoni L, Marcacci M (2009) Minimally invasive unicompartmental knee replacement: retrospective clinical and radiographic evaluation of 83 patients. Knee Surg Sports Traumatol Arthrosc 18(6):710–717

    Article  PubMed  Google Scholar 

  7. Carlsson LV, Albrektsson BE, Regnér LR (2006) Minimally invasive surgery vs conventional exposure using the Miller–Galante unicompartmental knee arthroplasty: a randomized radiostereometric study. J Arthroplasty 21(2):151–156

    Article  PubMed  Google Scholar 

  8. Choy WS, Kim KJ, Lee SK, Yang DS, Lee NK (2011) Mid-term results of oxford medial unicompartmental knee arthroplasty. Clin Orthop Surg 3(3):178–183

    Article  PubMed Central  PubMed  Google Scholar 

  9. Clement ND, Duckworth AD, MacKenzie SP, Nie YX, Tiemessen CH (2012) Medium-term results of Oxford phase-3 medial unicompartmental knee arthroplasty. J Orthop Surg (Hong Kong) 20(2):157–161

    Google Scholar 

  10. Ensini A, Barbadoro P, Leardini A, Catani F, Giannini S (2013) Early migration of the cemented tibial component of unicompartmental knee arthroplasty: a radiostereometry study. Knee Surg Sport Traumatol Arthrosc 21:2474–2479

    Article  Google Scholar 

  11. Grewal R, Rimmer MG, Freeman MA (1992) Early migration of prostheses related to long-term survivorship. Comparison of tibial components in knee replacement. J Bone Joint Surg Br 74(2):239–242

    CAS  PubMed  Google Scholar 

  12. Hanssen AD, Stuart MJ, Scott RD, Scuderi GR (2001) Surgical options for the middle-aged patient with osteoarthritis of the knee joint. Instr Course Lect 50:499–511

    CAS  PubMed  Google Scholar 

  13. Hansson U, Toksvig-Larsen S, Jorn LP, Ryd L (2005) Mobile vs. fixed meniscal bearing in total knee replacement: a randomised radiostereometric study. Knee 12(6):414–418

    Article  PubMed  Google Scholar 

  14. Kaptein BL, Valstar ER, Stoel BC, Reiber HC, Nelissen RG (2007) Clinical validation of model-based RSA for a total knee prosthesis. Clin Orthop Relat Res 464:205–209

    PubMed  Google Scholar 

  15. Kärrholm J, Gill RH, Valstar ER (2006) The history and future of radiostereometric analysis. Clin Orthop Relat Res 448:10–21

    Article  PubMed  Google Scholar 

  16. Kärrholm J (1989) Roentgen stereophotogrammetry. Review of orthopedic applications. Acta Orthop Scand 60(4):491–503

    Article  PubMed  Google Scholar 

  17. Lindstrand A, Stenström A, Ryd L, Toksvig-Larsen S (2000) The introduction period of unicompartmental knee arthroplasty is critical: a clinical, clinical multicentered, and radiostereometric study of 251 Duracon unicompartmental knee arthroplasties. J Arthroplasty 15(5):608–616

    Article  CAS  PubMed  Google Scholar 

  18. Molt M, Ljung P, Toksvig-Larsen S (2012) Does a new knee design perform as well as the design it replaces? Bone Joint Res 1(12):315–323

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Nakama GY, Peccin MS, Almeida GJ, Lira Neto Ode A, Queiroz AA, Navarro RD (2012) Cemented, cementless or hybrid fixation options in total knee arthroplasty for osteoarthritis and other non-traumatic diseases. Cochrane Database Syst Rev 10:CD006193

    PubMed  Google Scholar 

  20. Nilsson KG, Karrholm J (1993) Increased varus–valgus tilting of screw-fixated knee prostheses. Stereoradiographic study of uncemented versus cemented tibial components. J Arthroplasty 8(5):529–540

    Article  CAS  PubMed  Google Scholar 

  21. Nilsson KG, Karrholm J, Carlsson L, Dalen T (1999) Hydroxyapatite coating versus cemented fixation of the tibial component in total knee arthroplasty—prospective randomized comparison of hydroxyapatite-coated and cemented tibial components with 5 years follow-up using radiostereometry. J Arthroplasty 14(1):9–20

    Article  CAS  PubMed  Google Scholar 

  22. Regnér L, Carlsson L, Kärrholm J, Herberts P (2000) Tibial component fixation in porous- and hydroxyapatite-coated total knee arthroplasty: a radiostereometric evaluation of migration and inducible displacement after 5 years. J Arthroplasty 15(6):681–689

    Article  PubMed  Google Scholar 

  23. Ridgeway SR, McAuley JP, Ammeen DJ, Engh GA (2002) The effect of alignment of the knee on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br 84(3):351–355

    Article  CAS  PubMed  Google Scholar 

  24. Ryd L, Albrektsson BE, Carlsson L, Dansgård F, Herberts P, Lindstrand A, Regnér L, Toksvig-Larsen S (1995) Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 77(3):377–383

    CAS  PubMed  Google Scholar 

  25. Ryd L, Linstrand A, Strenstrom A, Selvik G (1992) The influence of metal backing in unicompartmental tibial component fixation: an in vivo roentgen stereophotogrammetric analysis of micromotion. Arch Orthop Trauma Surg 111:148

    Article  CAS  PubMed  Google Scholar 

  26. Saleh KJ, Macaulay A, Radosevich DM et al (2001) The Knee Society Index of Severity for failed total knee arthroplasty: development and validation. Clin Orthop Relat Res 392:153–165

    Article  PubMed  Google Scholar 

  27. Schai PA, Suh JT, Thornhill TS, Scott RD (1998) Unicompartmental knee arthroplasty in middle-aged patients: a 2- to 6-year follow-up evaluation. J Arthroplasty 13(4):365–372

    Article  CAS  PubMed  Google Scholar 

  28. Selvik G (1989) Roentgen stereophotogrammetry. A method for the study of the kinematics of the skeletal system. Acta Orthop Scand Suppl. 232:1–51

    Article  Google Scholar 

  29. Selvik G, Alberius P, Aronson AS (1983) A roentgen stereophotogrammetric system: construction, calibration and technical accuracy. Acta Radiol Diagn (Stockh) 24(4):343–352

    CAS  Google Scholar 

  30. Soavi R, Loreti I, Bragonzoni L, La Palombara P, Visani A, Marcacci M (2002) A Roentgen stereophotogrammetric analysis of unicompartmental knee arthroplasty. J Arthroplasty 17(5):556–561

    Article  PubMed  Google Scholar 

  31. Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A (2001) High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7–10-year follow-up prospective randomised study. Knee 8(3):187–194

    Article  CAS  PubMed  Google Scholar 

  32. Tägil M, Hansson U, Sigfusson R, Carlsson A, Johnell O, Lidgren L, Toksvig-Larsen S, Ryd L (2003) Bone morphology in relation to the migration of porous-coated anatomic knee arthroplasties : a roentgen stereophotogrammetric and histomorphometric study in 23 knees. J Arthroplasty 18(5):649–653

    Article  PubMed  Google Scholar 

  33. Valstar ER, Gill R, Ryd L, Flivik G, Borlin N, Karrholm J (2005) Guidelines for standardization of radiostereometry (RSA) of implants. Acta Orthop 64(4):563–572

    Article  Google Scholar 

  34. Wilson DA, Richardson G, Hennigar AW, Dunbar MJ (2011) Continued stabilization of trabecular metal tibial monoblock total knee arthroplasty components at 5 years-measured with radiostereometric analysis. Acta Orthop 83(1):36–40

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Biomechanics and Technological Innovation Laboratory, Codivilla-Putti Research Center, Rizzoli Orthopaedic Institute, Bologna University, Via Di Barbiano 1-10, 40136, Bologna, Italy

    Danilo Bruni, Michele Gagliardi, Marco Bontempi, Ibrahim Akkawi, Giovanni Francesco Raspugli, Francesco Iacono, Silvio Patella & Maurilio Marcacci

  2. Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), Univeristà di Bologna, Bologna, Italy

    Laura Bragonzoni

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  1. Danilo Bruni
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  2. Laura Bragonzoni
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Correspondence to Danilo Bruni.

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Bruni, D., Bragonzoni, L., Gagliardi, M. et al. Roentgen stereophotogrammetric analysis: an effective tool to predict implant survival after an all-poly unicompartmental knee arthroplasty—a 10 year follow-up study. Knee Surg Sports Traumatol Arthrosc 23, 3273–3280 (2015). https://doi.org/10.1007/s00167-014-3106-2

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  • DOI: https://doi.org/10.1007/s00167-014-3106-2

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