Skip to main content
Top
Published in: International Orthopaedics 5/2010

01-06-2010 | Original Paper

The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients

Authors: Jaakko Järvenpää, Jukka Kettunen, Hannu Miettinen, Heikki Kröger

Published in: International Orthopaedics | Issue 5/2010

Login to get access

Abstract

When unicompartmental knee arthroplasty (UKA) failure occurs, a revision procedure to total knee arthroplasty (TKA) is often necessary. We compared the long-term results of this procedure to primary TKA and evaluated whether they are clinically comparable. Twenty-one patients underwent UKA conversion to TKA between 1991 and 2000. The results of these patients were compared to the group of 28 primary TKA patients with the same age, sex and operation time point. The long-term outcomes were evaluated using clinical and radiological analysis. The mean follow-up period of the patients was 10.5 years. The UKA revision patients were more dissatisfied, as measured by the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scale (0–100 mm) compared to the primary TKA patients (pain 18.1/7.8; p = 0.014; stiffness 25.7/14.4, p = 0.024; physical function 19.0/14.8, p = 0.62). Two patients were revised twice in the UKA revision group. There was one revision in the primary TKA group (p = 0.39). Improvement in range of motion (ROM) was better in the TKA patients compared to the UKA revision patients (8.2°/–2.6°, p = 0.0001). We suggest that UKA conversion to TKA is associated with poorer clinical outcome as compared to primary TKA.
Literature
1.
go back to reference Barret WP, Scott RD (1987) Revision of failed unicondylar arthroplasty. J Bone Joint Surg Am 69:1328–1335 Barret WP, Scott RD (1987) Revision of failed unicondylar arthroplasty. J Bone Joint Surg Am 69:1328–1335
2.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell C, Stitt LW (1988) 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 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell C, Stitt LW (1988) 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 15:1833–1840PubMed
3.
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 87:999–1006CrossRefPubMed 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 87:999–1006CrossRefPubMed
4.
go back to reference Bray GA (1987) Overweight is risking fate: definition, classification, prevalence and risks. Ann NY Acad Sci 9:14–29CrossRef Bray GA (1987) Overweight is risking fate: definition, classification, prevalence and risks. Ann NY Acad Sci 9:14–29CrossRef
5.
go back to reference Böhm I, Landsiedl F (2000) Revision surgery after failed unicompartmental knee arthroplasty. A study of 35 cases. J Arthroplasty 15:982–989CrossRefPubMed Böhm I, Landsiedl F (2000) Revision surgery after failed unicompartmental knee arthroplasty. A study of 35 cases. J Arthroplasty 15:982–989CrossRefPubMed
6.
go back to reference Chakrabarty G, Newman JH, Ackroyd CE (1998) Revision of unicompartmental arthroplasty of the knee. Clinical and technical considerations. J Arthroplasty 13:191–196CrossRefPubMed Chakrabarty G, Newman JH, Ackroyd CE (1998) Revision of unicompartmental arthroplasty of the knee. Clinical and technical considerations. J Arthroplasty 13:191–196CrossRefPubMed
7.
go back to reference Dudley TE, Gioe TJ, Sinner P, Mehle S (2008) Registry outcomes of unicompartmental knee arthroplasty revisions. Clin Orthop Relat Res 466:1666–1670CrossRefPubMed Dudley TE, Gioe TJ, Sinner P, Mehle S (2008) Registry outcomes of unicompartmental knee arthroplasty revisions. Clin Orthop Relat Res 466:1666–1670CrossRefPubMed
8.
go back to reference Gioe TJ, Novak C, Sinner P, Ma W, Mehle S (2007) Knee arthroplasty in the young patient: survival in a community registry. Clin Orthop Relat Res 464:83–87PubMed Gioe TJ, Novak C, Sinner P, Ma W, Mehle S (2007) Knee arthroplasty in the young patient: survival in a community registry. Clin Orthop Relat Res 464:83–87PubMed
9.
go back to reference Griffin T, Rowden N, Morgan D, Atkinson R, Woodruff P, Maddern G (2007) Unicompartmental knee arthroplasty for the treatment of unicompartmental osteoarthritis: A systematic study. ANZ J Surg 77:214–221CrossRefPubMed Griffin T, Rowden N, Morgan D, Atkinson R, Woodruff P, Maddern G (2007) Unicompartmental knee arthroplasty for the treatment of unicompartmental osteoarthritis: A systematic study. ANZ J Surg 77:214–221CrossRefPubMed
10.
go back to reference Harrysson OL, Robertsson O, Nayfeh JF (2004) Higher cumulative revision rate of knee arthroplasties in younger patients with osteoarthritis. Clin Orthop Relat Res 421:162–168CrossRefPubMed Harrysson OL, Robertsson O, Nayfeh JF (2004) Higher cumulative revision rate of knee arthroplasties in younger patients with osteoarthritis. Clin Orthop Relat Res 421:162–168CrossRefPubMed
11.
go back to reference Insall J, Walker P (1976) Unicondylar knee replacement. Clin Orthop Relat Res 120:83–85PubMed Insall J, Walker P (1976) Unicondylar knee replacement. Clin Orthop Relat Res 120:83–85PubMed
12.
go back to reference Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V (2007) Unicondylar knee replacement for primary osteoarthritis. A prospective follow-up study of 1,819 patients from the finnish arthroplasty register. Acta Orthop 78:128–135CrossRefPubMed Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V (2007) Unicondylar knee replacement for primary osteoarthritis. A prospective follow-up study of 1,819 patients from the finnish arthroplasty register. Acta Orthop 78:128–135CrossRefPubMed
13.
go back to reference Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) 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 79:499–507CrossRefPubMed Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) 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 79:499–507CrossRefPubMed
14.
go back to reference Kostuik JP, Schmidt O, Harris WR, Wooldridge C (1975) A study of weight transmission through the knee joint with applied varus and valgus loads. Clin Orthop Relat Res 108:95–98CrossRefPubMed Kostuik JP, Schmidt O, Harris WR, Wooldridge C (1975) A study of weight transmission through the knee joint with applied varus and valgus loads. Clin Orthop Relat Res 108:95–98CrossRefPubMed
15.
go back to reference Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71:145–150PubMed Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71:145–150PubMed
16.
go back to reference Levine WN, Ozuna RM, Scott RD, Thornhill TS (1996) Conversion of failed modern unicompartmental arthroplasty to total knee arthroplasty. J Arthroplasty 11:797–801CrossRefPubMed Levine WN, Ozuna RM, Scott RD, Thornhill TS (1996) Conversion of failed modern unicompartmental arthroplasty to total knee arthroplasty. J Arthroplasty 11:797–801CrossRefPubMed
17.
go back to reference Luscombe KL, Lim J, Jones PW, White SH (2007) Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! Int Orthop 31:321–324CrossRefPubMed Luscombe KL, Lim J, Jones PW, White SH (2007) Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! Int Orthop 31:321–324CrossRefPubMed
18.
go back to reference Mathias S, Nayak U, Isaacs B (1986) Balance in elderly patients. The “get-up and go” test. Arch Phys Med Rehabil 67:387–389PubMed Mathias S, Nayak U, Isaacs B (1986) Balance in elderly patients. The “get-up and go” test. Arch Phys Med Rehabil 67:387–389PubMed
19.
go back to reference Miller M, Benjamin JB, Marson B, Hollstien S (2002) The effect of implant constraint on results of conversion of unicompartmental knee arthroplasty to total knee arthroplasty. Orthopedics 25:1353–1357PubMed Miller M, Benjamin JB, Marson B, Hollstien S (2002) The effect of implant constraint on results of conversion of unicompartmental knee arthroplasty to total knee arthroplasty. Orthopedics 25:1353–1357PubMed
20.
go back to reference Murray DW, Goodfellow JW, O' Connor JJ (1998) The Oxford medial unicompartmental arthroplasty. A ten-year survival study. J Bone Joint Surg Br 80:983–989CrossRefPubMed Murray DW, Goodfellow JW, O' Connor JJ (1998) The Oxford medial unicompartmental arthroplasty. A ten-year survival study. J Bone Joint Surg Br 80:983–989CrossRefPubMed
21.
go back to reference Robertsson O, Borgquist L, Knutson K, Lewold S, Lindgren L (1999) Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses. Acta Orthop Scand 70:170–175PubMedCrossRef Robertsson O, Borgquist L, Knutson K, Lewold S, Lindgren L (1999) Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses. Acta Orthop Scand 70:170–175PubMedCrossRef
22.
23.
go back to reference Skolnick MD, Bryan RS, Peterson LF (1975) Unicompartmental polycentric knee arthroplasty: description and preliminary results. Clin Orthop Relat Res 112:208–214CrossRefPubMed Skolnick MD, Bryan RS, Peterson LF (1975) Unicompartmental polycentric knee arthroplasty: description and preliminary results. Clin Orthop Relat Res 112:208–214CrossRefPubMed
24.
go back to reference Soohoo NF, Sharifi H, Kominski G, Lieberman JR (2006) Cost-effectiveness analysis of unicompartmental knee arthroplasty as an alternative to total knee arthroplasty for unicompartmental osteoarthritis. J Bone Joint Surg Am 88:1975–1982CrossRefPubMed Soohoo NF, Sharifi H, Kominski G, Lieberman JR (2006) Cost-effectiveness analysis of unicompartmental knee arthroplasty as an alternative to total knee arthroplasty for unicompartmental osteoarthritis. J Bone Joint Surg Am 88:1975–1982CrossRefPubMed
25.
go back to reference Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84(Suppl 2):90–98PubMed Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84(Suppl 2):90–98PubMed
26.
go back to reference Tabor OW Jr, Tabor OW (1998) Unicompartmental arthroplasty. A long-term follow-up study. J Arthroplasty 13:373–379CrossRefPubMed Tabor OW Jr, Tabor OW (1998) Unicompartmental arthroplasty. A long-term follow-up study. J Arthroplasty 13:373–379CrossRefPubMed
27.
go back to reference Walton P, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116PubMed Walton P, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116PubMed
Metadata
Title
The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients
Authors
Jaakko Järvenpää
Jukka Kettunen
Hannu Miettinen
Heikki Kröger
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 5/2010
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-009-0811-4

Other articles of this Issue 5/2010

International Orthopaedics 5/2010 Go to the issue