Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2016

01-01-2016 | Knee

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

Authors: Danilo Bruni, Michele Gagliardi, Ibrahim Akkawi, Giovanni Francesco Raspugli, Simone Bignozzi, Tedi Marko, Laura Bragonzoni, Alberto Grassi, Maurilio Marcacci

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2016

Login to get access

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.
Literature
1.
go back to reference Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty 23:159–163PubMedCrossRef Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty 23:159–163PubMedCrossRef
2.
go back to reference 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 451:101–106PubMedCrossRef 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 451:101–106PubMedCrossRef
3.
go back to reference 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):2235–2239PubMed 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):2235–2239PubMed
4.
go back to reference Argenson JN, Parratte S (2006) The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res 452:137–142PubMedCrossRef Argenson JN, Parratte S (2006) The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res 452:137–142PubMedCrossRef
5.
go back to reference Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36PubMed Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36PubMed
6.
go back to reference 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):104–108PubMedCrossRef 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):104–108PubMedCrossRef
7.
go back to reference 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):999–1006PubMedCrossRef 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):999–1006PubMedCrossRef
8.
go back to reference Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16(1):9–18PubMed Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16(1):9–18PubMed
9.
go back to reference 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 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.
go back to reference 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):1442–1451PubMedPubMedCentralCrossRef 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):1442–1451PubMedPubMedCentralCrossRef
11.
go back to reference 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):710–717PubMedCrossRef 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):710–717PubMedCrossRef
12.
go back to reference 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):62–65PubMed 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):62–65PubMed
13.
go back to reference 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–S225PubMedCrossRef 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–S225PubMedCrossRef
14.
go back to reference 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):200–206PubMedCrossRef 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):200–206PubMedCrossRef
15.
go back to reference 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):469–474PubMedCrossRef 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):469–474PubMedCrossRef
16.
go back to reference 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):98–107PubMedCrossRef 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):98–107PubMedCrossRef
17.
go back to reference Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86:506–511PubMed Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86:506–511PubMed
18.
go back to reference 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):1715–1720PubMedPubMedCentralCrossRef 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):1715–1720PubMedPubMedCentralCrossRef
19.
go back to reference 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):174–179PubMedCrossRef 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):174–179PubMedCrossRef
20.
go back to reference 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):48–52PubMedCrossRef 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):48–52PubMedCrossRef
21.
go back to reference Levine M, Ensom MH (2001) Post hoc power analysis: an idea whose time has passed? Pharmacotherapy 21(4):405–409PubMedCrossRef Levine M, Ensom MH (2001) Post hoc power analysis: an idea whose time has passed? Pharmacotherapy 21(4):405–409PubMedCrossRef
22.
go back to reference 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):176–179PubMedCrossRef 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):176–179PubMedCrossRef
23.
go back to reference 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):12–21CrossRef 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):12–21CrossRef
24.
go back to reference Mariani EM, Bourne MH, Jackson RT, Jackson ST, Jones P (2007) Early failure of unicompartmental knee arthroplasty. J Arthroplasty 22(6 Suppl 2):81–84PubMedCrossRef Mariani EM, Bourne MH, Jackson RT, Jackson ST, Jones P (2007) Early failure of unicompartmental knee arthroplasty. J Arthroplasty 22(6 Suppl 2):81–84PubMedCrossRef
25.
go back to reference 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):7–11PubMedCrossRef 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):7–11PubMedCrossRef
26.
go back to reference 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):461–465PubMedCrossRef 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):461–465PubMedCrossRef
27.
go back to reference Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15(1):17–22PubMed Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15(1):17–22PubMed
28.
go back to reference 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):53–56PubMedCrossRef 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):53–56PubMedCrossRef
29.
go back to reference 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):365–372PubMedCrossRef 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):365–372PubMedCrossRef
30.
go back to reference Schmalzried TP, Shepherd EF, Dorey FJ et al (2000) Wear is a function of use, not time. Clin Orthop 381:36–46 Schmalzried TP, Shepherd EF, Dorey FJ et al (2000) Wear is a function of use, not time. Clin Orthop 381:36–46
31.
go back to reference 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–S234PubMedCrossRef 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–S234PubMedCrossRef
32.
go back to reference 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):201–205PubMedCrossRef 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):201–205PubMedCrossRef
33.
go back to reference 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):90–94PubMedPubMedCentralCrossRef 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):90–94PubMedPubMedCentralCrossRef
34.
go back to reference Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplasty 20(4 Suppl 2):2–3PubMedCrossRef Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplasty 20(4 Suppl 2):2–3PubMedCrossRef
35.
go back to reference 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 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
Metadata
Title
Good survivorship of all-polyethylene tibial component UKA at long-term follow-up
Authors
Danilo Bruni
Michele Gagliardi
Ibrahim Akkawi
Giovanni Francesco Raspugli
Simone Bignozzi
Tedi Marko
Laura Bragonzoni
Alberto Grassi
Maurilio Marcacci
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3361-2

Other articles of this Issue 1/2016

Knee Surgery, Sports Traumatology, Arthroscopy 1/2016 Go to the issue