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Does Bearing Design Influence Midterm Survivorship of Unicompartmental Arthroplasty?

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
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Clinical Orthopaedics and Related Research®

Abstract

Medial unicompartmental arthroplasties (UKA) are available with mobile- and fixed-bearing designs, with the advantages of one bearing over another unproven. We questioned whether the bearing design influenced clinical outcome, survivorship, the reason for revision, or the timing of failures. We retrospectively reviewed 179 patients (229 knees) who had medial unicompartmental knee arthroplasties between 1990 and 2007; of these 79 knees had a mobile-bearing design and 150 knees a fixed-bearing design. Patients with mobile-bearing UKA had a minimum followup of 1 year (mean, 3.6 years; range, 1–11.3 years); those with fixed-bearing UKA a minimum followup of 1 year (mean, 8.1 years; range, 1–17.8 years). Patients were evaluated with clinical outcome scores and radiographically using the Knee Society rating system. Seven of 79 (9%) mobile-bearing knees underwent revision at a mean of 2.6 years, and 22 of 150 (15%) fixed-bearing knees underwent revision at a mean of 6.9 years. The 5-year cumulative survival rates were 88% (SE ± 0.47, 95% CI 0.7229–1) and 96% (SE ± 0.16, 95% CI 0.93–0.9979) for the mobile- and fixed-bearing designs respectively using the endpoint of revision surgery. We observed no differences in the indications or complexity of revision surgery between the groups and none in midterm survivorship.

Level of Evidence: Level III, comparative study. See Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Akizuki S, Mueller JK, Horiuchi H, Matsunaga D, Shibakawa A, Komistek RD. In vivo determination of kinematics for subjects having a Zimmer unicompartmental high flex Knee System. J Arthroplasty. 2008 Aug 11. [Epub ahead of print].

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  5. Ashraf T, Newman JH, Desai VV, Beard D, Nevelos JE. Polyethylene wear in a non-congruous unicompartmental knee replacement: a retrieval analysis. Knee. 2004;11:177–181.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  7. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.

    CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  9. Bohm I, Landsiedl F. Revision surgery after failed unicompartmental knee arthroplasty: a study of 35 cases. J Arthroplasty. 2000;15:982–989.

    Article  CAS  PubMed  Google Scholar 

  10. Chakrabarty G, Newman JH, Ackroyd CE. Revision of unicompartmental arthroplasty of the knee. Clinical and technical considerations. J Arthroplasty. 1998;13:191–196.

    Article  CAS  PubMed  Google Scholar 

  11. Confalonieri N, Manzotti A, Pullen C. Comparison of a mobile with a fixed tibial bearing unicompartimental knee prosthesis: a prospective randomized trial using a dedicated outcome score. Knee. 2004;11:357–362.

    Article  CAS  PubMed  Google Scholar 

  12. Dudley TE, Gioe TJ, Sinner P, Mehle S. Registry outcomes of unicompartmental knee arthroplasty revisions. Clin Orthop Relat Res. 2008;466:1666–1670.

    Article  PubMed  Google Scholar 

  13. Emerson RH, Jr, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL. Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res. 2002;404:62–70.

    Article  PubMed  Google Scholar 

  14. Emerson RH, Jr, Higgins LL. Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am. 2008;90:118–122.

    Article  PubMed  Google Scholar 

  15. Furnes O, Espehaug B, Lie SA, Vollset SE, Engesaeter LB, Havelin LI. Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with cement. J Bone Joint Surg Am. 2007;89:519–525.

    Article  CAS  PubMed  Google Scholar 

  16. Gioe TJ, Killeen KK, Hoeffel DP, Bert JM, Comfort TK, Scheltema K, Mehle S, Grimm K. Analysis of unicompartmental knee arthroplasty in a community-based implant registry. Clin Orthop Relat Res. 2003;416:111–119.

    Article  PubMed  Google Scholar 

  17. Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman JH. Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. Knee. 2004;11:379–384.

    Article  CAS  PubMed  Google Scholar 

  18. Hollinghurst D, Stoney J, Ward T, Gill HS, Newman JH, Murray DW, Beard DJ. No deterioration of kinematics and cruciate function 10 years after medial unicompartmental arthroplasty. Knee. 2006;13:440–444.

    Article  CAS  PubMed  Google Scholar 

  19. Hopper GP, Leach WJ. Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc. 2008;16:973–979.

    Article  PubMed  Google Scholar 

  20. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980;62:1329–1337.

    CAS  PubMed  Google Scholar 

  21. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;13–14.

  22. Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW. Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee. 2007;14:212–217.

    Article  CAS  PubMed  Google Scholar 

  23. Jeer PJ, Cossey AJ, Keene GC. Haemoglobin levels following unicompartmental knee arthroplasty: influence of transfusion practice and surgical approach. Knee. 2005;12:358–361.

    Article  PubMed  Google Scholar 

  24. Johnson S, Jones P, Newman JH. The survivorship and results of total knee replacements converted from unicompartmental knee replacements. Knee. 2007;14:154–157.

    Article  PubMed  Google Scholar 

  25. Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79:499–507.

    Article  PubMed  Google Scholar 

  26. Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V. Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007;78:128–135.

    Article  PubMed  Google Scholar 

  27. Lai CH, Rand JA. Revision of failed unicompartmental total knee arthroplasty. Clin Orthop Relat Res. 1993;287:193–201.

    PubMed  Google Scholar 

  28. Levine WN, Ozuna RM, Scott RD, Thornhill TS. Conversion of failed modern unicompartmental arthroplasty to total knee arthroplasty. J Arthroplasty. 1996;11:797–801.

    Article  CAS  PubMed  Google Scholar 

  29. Lewold S, Goodman S, Knutson K, Robertsson O, Lidgren L. Oxford meniscal bearing knee versus the Marmor knee in unicompartmental arthroplasty for arthrosis. A Swedish multicenter survival study. J Arthroplasty. 1995;10:722–731.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  31. Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs. fixed bearing unicondylar knee arthroplasty: A randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13:365–370.

    Article  PubMed  Google Scholar 

  32. Lindstrand A, Stenstrom A, Lewold S. Multicenter study of unicompartmental knee revision. PCA, Marmor, and St Georg compared in 3,777 cases of arthrosis. Acta Orthop Scand. 1992;63:256–259.

    Article  CAS  PubMed  Google Scholar 

  33. McAuley JP, Engh GA, Ammeen DJ. Revision of failed unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2001;392:279–282.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  35. Naudie D, Guerin J, Parker DA, Bourne RB, Rorabeck CH. Medial unicompartmental knee arthroplasty with the Miller-Galante prosthesis. J Bone Joint Surg Am. 2004;86:1931–1935.

    PubMed  Google Scholar 

  36. Newman JH, Ackroyd CE, Shah NA. Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br. 1998;80:862–865.

    Article  CAS  PubMed  Google Scholar 

  37. O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, Sullivan PM, Johnston RC. The John Insall Award: unicompartmental knee replacement: a minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res. 2005;440:27–37.

    Article  PubMed  Google Scholar 

  38. Padgett DE, Stern SH, Insall JN. Revision total knee arthroplasty for failed unicompartmental replacement. J Bone Joint Surg Am. 1991;73:186–190.

    CAS  PubMed  Google Scholar 

  39. Palmer SH, Morrison PJ, Ross AC. Early catastrophic tibial component wear after unicompartmental knee arthroplasty. Clin Orthop Relat Res. 1998;350:143–148.

    Article  PubMed  Google Scholar 

  40. Patil S, Colwell CW, Jr, Ezzet KA, D’Lima DD. Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am. 2005;87:332–338.

    Article  PubMed  Google Scholar 

  41. Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am. 2003;85:1968–1973.

    PubMed  Google Scholar 

  42. Price AJ, Oppold PT, Murray DW, Zavatsky AB. Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement. J Bone Joint Surg Br. 2006;88:1591–1595.

    Article  CAS  PubMed  Google Scholar 

  43. Price AJ, Rees JL, Beard DJ, Gill RH, Dodd CA, Murray DM. Sagittal plane kinematics of a mobile-bearing unicompartmental knee arthroplasty at 10 years: a comparative in vivo fluoroscopic analysis. J Arthroplasty. 2004;19:590–597.

    Article  PubMed  Google Scholar 

  44. Price AJ, Short A, Kellett C, Beard D, Gill H, Pandit H, Dodd CA, Murray DW. Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty. J Bone Joint Surg Br. 2005;87:1493–1497.

    Article  CAS  PubMed  Google Scholar 

  45. Price AJ, Waite JC, Svard U. Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2005;435:171–180.

    Article  PubMed  Google Scholar 

  46. Price AJ, Webb J, Topf H, Dodd CA, Goodfellow JW, Murray DW. Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplasty. 2001;16:970–976.

    Article  CAS  PubMed  Google Scholar 

  47. Psychoyios V, Crawford RW, O’Connor JJ, Murray DW. Wear of congruent meniscal bearings in unicompartmental knee arthroplasty: a retrieval study of 16 specimens. J Bone Joint Surg Br. 1998;80:976–982.

    Article  CAS  PubMed  Google Scholar 

  48. Robertsson O, Knutson K, Lewold S, Lidgren L. The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Joint Surg Br. 2001;83:45–49.

    Article  CAS  PubMed  Google Scholar 

  49. Robertsson O, Lidgren L. The short-term results of 3 common UKA implants during different periods in Sweden. J Arthroplasty. 2008;23:801–807.

    Article  PubMed  Google Scholar 

  50. Saldanha KA, Keys GW, Svard UC, White SH, Rao C. Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty—results of a multicentre study. Knee. 2007;14:275–279.

    Article  CAS  PubMed  Google Scholar 

  51. Saragaglia D, Estour G, Nemer C, Colle PE. Revision of 33 unicompartmental knee prostheses using total knee arthroplasty: strategy and results. Int Orthop. 2008 Jun 18. [Epub ahead of print].

  52. Simpson DJ, Gray H, D’Lima D, Murray DW, Gill HS. The effect of bearing congruency, thickness and alignment on the stresses in unicompartmental knee replacements. Clin Biomech (Bristol, Avon). 2008;23:1148–1157.

    Article  CAS  Google Scholar 

  53. Springer BD, Scott RD, Thornhill TS. Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res. 2006;446:214–220.

    Article  PubMed  Google Scholar 

  54. Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC. Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop Relat Res. 1999;367:61–72.

    Article  PubMed  Google Scholar 

  55. Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH. Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br. 2006;88:1164–1168.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  57. Tabor OB, Jr, Tabor OB. Unicompartmental arthroplasty: a long-term follow-up study. J Arthroplasty. 1998;13:373–379.

    Article  PubMed  Google Scholar 

  58. Tabor OB, Jr, Tabor OB, Bernard M, Wan JY. Unicompartmental knee arthroplasty: long-term success in middle-age and obese patients. J Surg Orthop Adv. 2005;14:59–63.

    PubMed  Google Scholar 

  59. Vorlat P, Putzeys G, Cottenie D, Van Isacker T, Pouliart N, Handelberg F, Casteleyn PP, Gheysen F, Verdonk R. The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis. Knee Surg Sports Traumatol Arthrosc. 2006;14:40–45.

    Article  PubMed  Google Scholar 

  60. Ware JJ, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Dr. C.H. Rorabeck for his patient contributions and Amarpreet Sanghera, Julie Marr, and Jeff Guerin for their help in the preparation of the manuscript.

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Authors and Affiliations

  1. Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, UK

    John-Paul Whittaker MB ChB, FRCS (T&O)

  2. Division of Orthopaedic Surgery, London Health Sciences Centre, University Campus, University of Western Ontario, London, ON, Canada

    Douglas D. R. Naudie MD, FRCS (C), James P. McAuley MD, FRCS (C), Richard W. McCalden MD, MPhil, FRCS (C), Steven J. MacDonald MD, FRCS (C) & Robert B. Bourne MD, FRCS (C)

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  1. John-Paul Whittaker MB ChB, FRCS (T&O)
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  2. Douglas D. R. Naudie MD, FRCS (C)
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  3. James P. McAuley MD, FRCS (C)
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  4. Richard W. McCalden MD, MPhil, FRCS (C)
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Correspondence to John-Paul Whittaker MB ChB, FRCS (T&O).

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the University Hospital, London Health Sciences Centre, London, Ontario, Canada.

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Whittaker, JP., Naudie, D.D.R., McAuley, J.P. et al. Does Bearing Design Influence Midterm Survivorship of Unicompartmental Arthroplasty?. Clin Orthop Relat Res 468, 73–81 (2010). https://doi.org/10.1007/s11999-009-0975-7

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