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Archives of Orthopaedic and Trauma Surgery

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01-08-2015 | Knee Arthroplasty

Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Authors: Michael W. Maier, Felix Kuhs, Marcus R. Streit, Peter Schuhmacher, Tilman Walker, Volker Ewerbeck, Tobias Gotterbarm

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2015

Abstract

Purpose

While the classical indications and contraindications for unicondylar knee arthroplasty (UKA) are widely accepted there is not yet consensus if patients with partial thickness cartilage loss (PTCL) are equally suited for treatment with UKA. The aim of our study was to determine if patients with partial thickness cartilage loss do equally well after treatment with UKA.

Methods

The study retrospectively analyzed the clinical results as well as the survival rates of 64 patients treated with UKA with the medial Oxford knee system. 32 patients had shown PTCL on preoperative radiographs, while the matched control group presented with full thickness cartilage loss (FTCL) medially. Outcome parameters were the Oxford Knee Score (OKS), the American Knee Society Score (AKS), and radiographic analysis.

Results

Postoperative improvement in OKS was 16 (SD 9.0) for patients with PTCL and 17 (SD 8.1) for patients with FTCL. There were no significant differences in the clinical scores between the two groups. Five Patients with PTCL had reoperation whereas there were only two in the bone on bone group. Cumulative survival at 5 years for all revisions was 84 % (95 % CI 72–92 %) for the PTCL group and 97 % (95 % CI 92–100 %) for the FTCL group. This difference was not yet significant (log rank: p = 0.095).

Conclusions

Patients with PTCL are not equally suited for treatment with UKA like patients with bone on bone. Although PTCL has equal clinical results, it was associated with higher revision rates in our series.

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

Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. Bone Joint J 91(1):52–57CrossRef

Manzotti A, Confalonieri N, Pullen C (2007) Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. Int Orthop 31(3):315–319PubMedCentralPubMedCrossRef

Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a 10-year survival study. Bone Joint J 80(6):983–989CrossRef

Pandit H et al (2011) Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment. Knee 18(3):168–171PubMedCrossRef

Niinimaki TT et al (2011) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 18(6):432–435PubMedCrossRef

Dawson J et al (1998) Questionnaire on the perceptions of patients about total knee replacement. Bone Joint J 80(1):63–69CrossRef

Insall JN et al (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed

Murray DW et al (2007) The use of the Oxford hip and knee scores. Bone Joint J 89(8):1010–1014CrossRef

10.

Price AJ, Svard U (2011) A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 469(1):174–179PubMedCentralPubMedCrossRef

11.

White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. Bone Joint J 73(4):582–586

12.

Aldinger PR et al (2004) Medial unicompartmental knee replacement using the “Oxford Uni” meniscal bearing knee. Der Orthopade 33(11):1277–1283PubMedCrossRef

13.

Mukherjee K et al (2008) The Oxford unicompartmental knee arthroplasty: a radiological perspective. Clin Radiol 63(10):1169–1176PubMedCrossRef

14.

Gibson PH, Goodfellow JW (1986) Stress radiography in degenerative arthritis of the knee. Bone Joint J 68(4):608–609

Title: Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL
Authors: Michael W. Maier
Felix Kuhs
Marcus R. Streit
Peter Schuhmacher
Tilman Walker
Volker Ewerbeck
Tobias Gotterbarm
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2236-4

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Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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