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Reliable patient-reported outcome measure and survivorship of UKA for primary spontaneous osteonecrosis

  • Original Article • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Primary Spontaneous osteonecrosis of the knee (SPONK) was a result of a subchondral insufficiency fracture based on histopathological examinations. There were few studies examining patients who underwent unicompartmental knee arthroplasty (UKA) for the treatment of primary SPONK. The aim of this study was to investigate (1) patient-reported outcome measure (PROM), (2) survivorship of revision as end point and (3) survivorship of complication as end point in patients with primary SPONK.

Methods

The clinical examinations of a consecutive series of 61 medial UKAs for primary SPONK of the medial femoral condyle from 2008 to 2012 were evaluated retrospectively at our institution. There were 18 males and 43 females with a mean age of 73.7 years (60–91). In all patients, preoperative radiographs were analyzed according to the stage of primary SPONK. We conducted Kaplan–Meier survival analyses using revision and complications for any reasons as the end point.

Results

Mean follow-up was 6.6 years (range 6–10). UKA using Physica ZUK (LIMA Corporate. UD, Italy) for SPONK improved patients’ 2011 Knee Society symptom score, patient satisfaction, patient activities, EQ-5D and postoperative ranges of motion compared with their preoperative status (P < 0.01). Revision surgery was required in one knee (1.6%) due to postoperative fracture of the medial tibial plateau after a fall that occurred 6 months postoperatively. The projected rate of survivorship of UKA was 90.4% at 10 years (95% confidence interval 0.80–1). The projected rate of survivorship with complication at end point was 87.7% at 10 years (95% confidence interval 0.76–0.99).

Conclusion

The present study demonstrated that primary spontaneous osteonecrosis of the knee (SPONK) can be successfully be treated with UKA at a mean follow-up of 6.6 years.

Level of evidence

II.

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Acknowledgements

The authors thank Hiroaki Suzuki for his assistance in this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan

    Takao Kaneko, Norihiko Kono, Takahide Sunakawa, Hiroyasu Ikegami & Yoshiro Musha

  2. Okuno Clinic, 7-8-4-4 Roppongi, Minato-ku, Tokyo, 106-0032, Japan

    Yuji Okuno

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  1. Takao Kaneko
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  2. Norihiko Kono
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  3. Takahide Sunakawa
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  4. Yuji Okuno
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  5. Hiroyasu Ikegami
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  6. Yoshiro Musha
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Correspondence to Takao Kaneko.

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Kaneko, T., Kono, N., Sunakawa, T. et al. Reliable patient-reported outcome measure and survivorship of UKA for primary spontaneous osteonecrosis. Eur J Orthop Surg Traumatol 29, 119–124 (2019). https://doi.org/10.1007/s00590-018-2296-6

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  • DOI: https://doi.org/10.1007/s00590-018-2296-6

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