Skip to main content

Advertisement

Log in

Good survivorship of all-polyethylene tibial component UKA at long-term follow-up

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

Abstract

Purposes

To determine the long-term survival rate of an all-polyethylene tibial unicompartmental knee arthroplasty (UKA) in a large series of consecutive patients and to investigate the possible factors that could influence the outcome.

Methods

A retrospective evaluation of 273 patients at 6–13 years of follow-up was performed. Clinical evaluation was based on KSS and WOMAC scores. Subjective evaluation was based on a visual analogue scale for pain self-assessment. Radiographic evaluation was performed to assess femoral-tibial angle (FTA), posterior tibial slope (PTS) and tibial plateau angle (TPA). A Kaplan–Meier survival analysis was performed assuming revision for any reason as primary endpoint.

Results

The 10-year implant survivorship was 87.6 %. Twenty-five revisions (9.2 %) were performed, and aseptic loosening of the tibial component was the most common failure mode (11 cases, 4 %). The comparison of survival rate according to age at surgery did not show significant difference. Age at surgery, FTA, TPA and PTS were not related to higher risk of revision. No correlations were found between BMI, age at surgery and clinical scores. Finally, no statistical differences of radiographic measurements were found between revisions and non-revisions.

Conclusions

The present study has demonstrated on a large series of patients that UKA with an all-polyethylene tibial component, with an accurate technique and a proper patient selection, can provide a satisfactory clinical and functional outcome and a good overall survivorship of the implant at long-term follow-up. These advantages could be achieved at a lower cost.

Level of evidence

Retrospective Therapeutic Study, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. 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 

  2. Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ (2006) Unicompartmental or total knee arthroplasty?: Results from a matched study. Clin Orthop Relat Res 451:101–106

    Article  PubMed  Google Scholar 

  3. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM (2002) Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. J Bone Joint Surg Am 84-A(12):2235–2239

    PubMed  Google Scholar 

  4. Argenson JN, Parratte S (2006) The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res 452:137–142

    Article  PubMed  Google Scholar 

  5. Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36

    PubMed  Google Scholar 

  6. Bauman S, Williams D, Petruccelli D et al (2007) Physical activity after total joint replacement: a cross-sectional survey. Clin J Sport Med 17(2):104–108

    Article  PubMed  Google Scholar 

  7. Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 87(5):999–1006

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  9. Bruni D, Akkawi I, Iacono F, Raspugli GF, Gagliardi M, Nitri M, Grassi A, Zaffagnini S, Bignozzi S, Marcacci M (2013) Minimum thickness of all-poly tibial component unicompartmental knee arthroplasty in patients younger than 60 years does not increase revision rate for aseptic loosening. Knee Surg Sports Traumatol Arthrosc 21(11):2462–2467

  10. 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(5):1442–1451

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bruni D, Iacono F, Russo A, Zaffagnini S, Muccioli GM, Bignozzi S, Bragonzoni L, Marcacci M (2010) 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 

  12. Cartier P, Khefacha A, Sanouiller JL, Frederick K (2007) Unicondylar knee arthroplasty in middle-aged patients: a minimum 5-year follow-up. Orthopedics 30(8 Suppl):62–65

    PubMed  Google Scholar 

  13. Chatellard R, Sauleau V, Colmar M et al (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99(4 Suppl):S219–S225

    Article  PubMed  CAS  Google Scholar 

  14. Goodman SN, Berlin JA (1994) The use of predicted confidence intervals when planning experiments and the misuse of power when interpreting results. Ann Intern Med 121(3):200–206

    Article  PubMed  CAS  Google Scholar 

  15. Gulati A, Pandit H, Jenkins C, Chau R, Dodd CA, Murray DW (2009) The effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br 91(4):469–474

    Article  PubMed  CAS  Google Scholar 

  16. Hamilton WG, Collier MB, Tarabee E, McAuley JP, Engh CA Jr, Engh GA (2006) Incidence and reasons for reoperation after minimally invasive unicompartmental knee arthroplasty. J Arthroplasty 21(6 Suppl 2):98–107

    Article  PubMed  Google Scholar 

  17. Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86:506–511

    PubMed  Google Scholar 

  18. Huch K, Müller KA, Stürmer T et al (2005) Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis 64(12):1715–1720

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Hyldahl HC, Regnér L, Carlsson L, Kärrholm J, Weidenhielm L (2001) Does metal backing improve fixation of tibial component in unicondylar knee arthroplasty? A randomized radiostereometric analysis. J Arthroplasty 16(2):174–179

    Article  PubMed  CAS  Google Scholar 

  20. Kuipers BM, Kollen BJ, Bots PC, Burger BJ, van Raay JJ, Tulp NJ, Verheyen CC (2009) Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee 17(1):48–52

    Article  PubMed  Google Scholar 

  21. Levine M, Ensom MH (2001) Post hoc power analysis: an idea whose time has passed? Pharmacotherapy 21(4):405–409

    Article  PubMed  CAS  Google Scholar 

  22. Lustig S, Barba N, Magnussen RA, Servien E, Demey G, Neyret P (2012) The effect of gender on outcome of unicompartmental knee arthroplasty. Knee 19(3):176–179

    Article  PubMed  CAS  Google Scholar 

  23. Lustig S, Paillot JL, Servien E, Henry J, Ait Si Selmi T, Neyret P (2008) Cemented all polyethylene tibial insert unicompartmental knee arthroplasty: a long term follow-up study. Orthop Traumatol Surg Res 95(1):12–21

    Article  Google Scholar 

  24. Mariani EM, Bourne MH, Jackson RT, Jackson ST, Jones P (2007) Early failure of unicompartmental knee arthroplasty. J Arthroplasty 22(6 Suppl 2):81–84

    Article  PubMed  Google Scholar 

  25. Mullaji AB, Sharma A, Marawar S (2007) Unicompartmental knee arthroplasty: functional recovery and radiographic results with a minimally invasive technique. J Arthroplasty 22(4 Suppl 1):7–11

    Article  PubMed  Google Scholar 

  26. Murray DW, Pandit H, Weston-Simons JS, Jenkins C, Gill HS, Lombardi AV, Dodd CA, Berend KR (2013) Does body mass index affect the outcome of unicompartmental knee replacement? Knee 20(6):461–465

    Article  PubMed  CAS  Google Scholar 

  27. Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15(1):17–22

    PubMed  Google Scholar 

  28. Saenz CL, McGrath MS, Marker DR, Seyler TM, Mont MA, Bonutti PM (2010) Early failure of a unicompartmental knee arthroplasty design with an all-polyethylene tibial component. Knee 17(1):53–56

    Article  PubMed  Google Scholar 

  29. 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  PubMed  CAS  Google Scholar 

  30. Schmalzried TP, Shepherd EF, Dorey FJ et al (2000) Wear is a function of use, not time. Clin Orthop 381:36–46

  31. Sébilo A, Casin C, Lebel B, Rouvillain JL, Chapuis S, Bonnevialle P (2013) Clinical and technical factors influencing outcomes of unicompartmental knee arthroplasty: retrospective multicentre study of 944 knees. Orthop Traumatol Surg Res 99(4 Suppl):S227–S234

    Article  PubMed  Google Scholar 

  32. Skyrme AD, Mencia MM, Skinner PW (2002) Early failure of the porous-coated anatomic cemented unicompartmental knee arthroplasty: a 5- to 9-year follow-up study. J Arthroplasty 17(2):201–205

    Article  PubMed  CAS  Google Scholar 

  33. W-Dahl A, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S (2010) Unicompartmental knee arthroplasty in patients aged less than 65. Acta Orthop 81(1):90–94

    Article  PubMed  PubMed Central  Google Scholar 

  34. Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplasty 20(4 Suppl 2):2–3

    Article  PubMed  Google Scholar 

  35. Zambianchi F, Digennaro V, Giorgini A, Grandi G, Fiacchi F, Mugnai R, Catani F (2014) Surgeon’s experience influences UKA survivorship: a comparative study between all-poly and metal back designs. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2958-9

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Danilo Bruni.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bruni, D., Gagliardi, M., Akkawi, I. et al. Good survivorship of all-polyethylene tibial component UKA at long-term follow-up. Knee Surg Sports Traumatol Arthrosc 24, 182–187 (2016). https://doi.org/10.1007/s00167-014-3361-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-014-3361-2

Keywords

Navigation