Abstract
Purpose
Unicompartmental knee arthroplasty (UKA) presents low morbidity and complication risk and provides excellent outcomes and fast recovery. Despite these facts, knee-replacement registries have shown high failure rates for UKA, especially when compared with traditional TKA. The purpose of this study was therefore to report outcomes, complications, and ten year survivorship rate of medial ZUK unicompartmental knee prosthesis.
Methods
We retrospectively analysed 136 medial UKAs in 124 patients, with a maximum follow-up of ten years. Patients were assessed through the International Knee Society (IKS) scores and range of motion (ROM). A complete X-ray study was performed in all patients. Limb alignment was assessed by measuring the femorotibial mechanical alignment. At surgery, bone resections were performed according to proximal tibial epiphyseal axis.
Results
Mean IKS knee score improved from 45.7 (range 35–63) points preoperatively to 87.2 (range 71–100) points at the latest follow-up. Mean IKS function score improved from 50.9 (range 40–70) points to 89.1 (range 75–100) points (p < 0.05). Mean ROM increased from 106.1° (range 98–123°) to 128.6° (range 116–139°) (p < 0.01). Four cases (2.9 %) were revised due to failure for any cause, so that survivorship was 97.1 % at the latest follow-up.
Conclusions
This study demonstrates excellent outcomes and survivorship for the ZUK unicompartmental knee prosthesis. Based on our findings, we believe that the ZUK prosthesis offers an effective and durable solution for treating medial degeneration of the knee.
Level of Evidence IV - Retrospective case series study
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References
Panni AS, Vasso M, Cerciello S, Felici A (2012) Unicompartmental knee replacement provides early clinical and functional improvement stabilizing over time. Knee Surg Sports Traumatol Arthrosc 20:579–585
Foran JR, Brown NM, Della Valle CJ, Berger RA, Galante JO (2013) Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res 471:102–108
Koshino T, Sato K, Umemoto Y, Akamatsu Y, Kumagai K, Saito T (2014) Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation. Int Orthop. doi:10.1007/s00264-014-2564-y
Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, Bontemps G (2014) Ten year survivorship after cemented and uncemented medial Uniglide® unicompartmental knee arthroplasties. Knee 21:964–970
Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9 Suppl):168–171
Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2014) Total versus unicompartmental knee replacement for isolated lateral osteoarthritis: a matched-pairs study. Int Orthop 38:2259–2264
Lim JW, Cousins GR, Clift BA, Ridley D, Johnston LR (2014) Oxford unicompartmental knee arthroplasty versus age and gender matched total knee arthroplasty—functional outcome and survivorship analysis. J Arthroplasty 29:1779–1783
Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P (2014) Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3131-1
Jahnke A, Mende JK, Maier GS, Ahmed GA, Ishaque BA, Schmitt H, Rickert M, Clarius M, Seeger JB (2015) Sports activities before and after medial unicompartmental knee arthroplasty using the new Heidelberg Sports Activity Score. Int Orthop 39:449–454
Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470:84–90
Niinimaki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI (2011) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 18:432–435
Schmiegelow MD, Andersson C, Køber L, Andersen SS, Norgaard ML, Jensen TB, Gislason G, Berger SM, Torp-Pedersen C (2014) Associations between body mass index and development of metabolic disorders in fertile women-a nationwide cohort study. J Am Heart Assoc 3, e000672
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22:117–121
Dao Trong ML, Diezi C, Goerres G, Helmy N (2014) Improved positioning of the tibial component in unicompartmental knee arthroplasty with patient-specific cutting blocks. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2839-2
Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165
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 84:2235–2239
Lustig S, Paillot J, Servien E, Henry J, Ait Si Selmi T, Neyret P (2009) Cemented all polyethylene tibial insert unicompartmental knee arthroplasty: a long term follow-up study. Arch Orthop Trauma Surg 129:617–624
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
Emerson RH Jr, Higgins LL (2008) Unicompartmental knee arthroplasty with the Oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 90:118–122
Hall MJ, Conell DA, Morris HG (2013) Medium to long-term results of the UNIX uncemented unicompartmental knee replacement. Knee 20:328–331
Koskinen E, Paavolainen P, Eskelinen A, Harilainen Ä, Sandelin J, Ylinen P, Tallroth K, Remes V (2009) Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: midterm clinical and radiographic results. Arch Orthop Trauma Surg 129:617–624
Berend KR, Morris MJ, Skeels MD, Lombardi AV Jr, Adams JB (2011) Perioperative complications of simultaneous versus staged unicompartmental knee arthroplasty. Clin Orthop Relat Res 469:168–173
Craik JD, El Shafie SA, Singh VK, Twyman RS (2014) Revision of unicompartmental knee arthroplasty versus primary total knee arthroplasty. J Arthroplasty. doi:10.1016/j.arth.2014.10.038
Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for H, Knee (2012) Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res 98(6 Suppl):S124–S130
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Vasso, M., Del Regno, C., Perisano, C. et al. Unicompartmental knee arthroplasty is effective: ten year results. International Orthopaedics (SICOT) 39, 2341–2346 (2015). https://doi.org/10.1007/s00264-015-2809-4
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DOI: https://doi.org/10.1007/s00264-015-2809-4