Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 1/2019

01-01-2019 | Knee Arthroplasty

A novel preoperative scoring system for the indication of unicompartmental knee arthroplasty, as predictor of clinical outcome and satisfaction

Authors: Alexander Antoniadis, Dimitris Dimitriou, Jean Pierre Canciani, Naeder Helmy

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2019

Login to get access

Abstract

Introduction

Proper patient selection is a crucial factor for the outcome of the unicompartmental knee arthroplasty (UKA). However, there is still not a clear consensus on which patients could benefit the utmost from a UKA. The purpose of this prospective study was to introduce a novel, preoperative, predictive score (Unicompartmental Indication Score, UIS) to aid proper patient selection in UKA.

Materials and methods

A total of 152 patients with an average age of 68 years and a mean follow-up of 27 months were evaluated preoperatively with the UIS and postoperative at every follow-up. Correlation analysis was applied to identify potential relationships between the UIS, functional outcomes, pain relief, patient satisfaction, and range of motion. The ROC analysis was used to identify the best cutoff value of the UIS, which would have predicted an optimal outcome following UKA.

Results

The majority of the patients (91%) were satisfied with the operation, with 61% reporting excellent and 30% good satisfaction. The UIS was positively correlated to the postoperative Knee Society Score (KSS) for both pain (r = 0.26, p < 0.001) and function (r = 0.31, p < 0.001). The UIS was also positively correlated to the patient satisfaction (p = 0.46, p < 0.001) and maximum postoperative flexion (r = 0.25, p < 0.001). The ROC analysis provided an ideal cutoff for UIS at 25 points (sensitivity: 75%, sensibility: 93%, area under the curve: 86%). At a mean follow-up of 27 months (range 24–37), we observed three revisions in 152 consecutive UKA with a mean UIS of 27 points (range 20–30).

Conclusions

The newly introduced UIS score might be a reliable preoperative scoring system to predict patients with excellent satisfaction, functional outcome, pain relief and possibly implant survivorship following UKA, and therefore, could help the proper patient selection and decision-making in UKA.

Level-of-evidence

Prospective study, II.
Literature
1.
go back to reference Centers for Disease C, Prevention (2009) Prevalence and most common causes of disability among adults–United States, 2005. MMWR Morb Mortal Wkly Rep 58(16):421–426 Centers for Disease C, Prevention (2009) Prevalence and most common causes of disability among adults–United States, 2005. MMWR Morb Mortal Wkly Rep 58(16):421–426
8.
go back to reference Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Jt Surg Am 71(1):145–150CrossRef Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Jt Surg Am 71(1):145–150CrossRef
9.
go back to reference Vasso M, Corona K, D’Apolito R, Mazzitelli G, Panni AS (2017) Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty. Jt 5(01):044–050 Vasso M, Corona K, D’Apolito R, Mazzitelli G, Panni AS (2017) Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty. Jt 5(01):044–050
10.
go back to reference Pennington DW, Swienckowski JJ, Lutes WB, Drake GN (2003) Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Jt Surg Am 85-A(10):1968–1973CrossRef Pennington DW, Swienckowski JJ, Lutes WB, Drake GN (2003) Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Jt Surg Am 85-A(10):1968–1973CrossRef
11.
go back to reference Tabor OB Jr, Tabor OB, Bernard M, Wan JY (2005) Unicompartmental knee arthroplasty: long-term success in middle-age and obese patients. J Surg Orthop Adv 14(2):59–63PubMed Tabor OB Jr, Tabor OB, Bernard M, Wan JY (2005) Unicompartmental knee arthroplasty: long-term success in middle-age and obese patients. J Surg Orthop Adv 14(2):59–63PubMed
13.
go back to reference Beard D, Pandit H, Ostlere S, Jenkins C, Dodd C, Murray D (2007) Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. Bone Jt J 89(12):1602–1607CrossRef Beard D, Pandit H, Ostlere S, Jenkins C, Dodd C, Murray D (2007) Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. Bone Jt J 89(12):1602–1607CrossRef
16.
go back to reference Rodriguez-Merchan EC (2016) Unicompartmental knee osteoarthritis (UKOA): unicompartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO)? Arch Bone Jt Surg 4(4):307–313PubMedPubMedCentral Rodriguez-Merchan EC (2016) Unicompartmental knee osteoarthritis (UKOA): unicompartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO)? Arch Bone Jt Surg 4(4):307–313PubMedPubMedCentral
19.
go back to reference Liow MHL, Tsai T-Y, Dimitriou D, Li G, Kwon Y-M (2016) Does 3-dimensional in vivo component rotation affect clinical outcomes in unicompartmental knee arthroplasty? J Arthroplast 31(10):2167–2172CrossRef Liow MHL, Tsai T-Y, Dimitriou D, Li G, Kwon Y-M (2016) Does 3-dimensional in vivo component rotation affect clinical outcomes in unicompartmental knee arthroplasty? J Arthroplast 31(10):2167–2172CrossRef
20.
go back to reference Kuipers BM, Kollen BJ, Bots PCK, Burger BJ, van Raay JJ, Tulp NJ, Verheyen CC (2010) Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee 17(1):48–52CrossRefPubMed Kuipers BM, Kollen BJ, Bots PCK, Burger BJ, van Raay JJ, Tulp NJ, Verheyen CC (2010) Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee 17(1):48–52CrossRefPubMed
23.
go back to reference Altman RD, Fries JF, Bloch DA, Carstens J, Mb D, Cooke T, Genant H, Gofton P, Groth H, Mcshane DJ (1987) Radiographic assessment of progression in osteoarthritis. Arthritis Rheumatol 30(11):1214–1225CrossRef Altman RD, Fries JF, Bloch DA, Carstens J, Mb D, Cooke T, Genant H, Gofton P, Groth H, Mcshane DJ (1987) Radiographic assessment of progression in osteoarthritis. Arthritis Rheumatol 30(11):1214–1225CrossRef
25.
go back to reference Argenson J-NA, Chevrol-Benkeddache Y, Aubaniac J-M (2002) Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. JBJS 84(12):2235–2239CrossRef Argenson J-NA, Chevrol-Benkeddache Y, Aubaniac J-M (2002) Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. JBJS 84(12):2235–2239CrossRef
27.
go back to reference van Campen C, Sixma H, Friele RD, Kerssens JJ, Peters L (1995) Quality of care and patient satisfaction: a review of measuring instruments. Med Care Res Rev 52(1):109–133CrossRefPubMed van Campen C, Sixma H, Friele RD, Kerssens JJ, Peters L (1995) Quality of care and patient satisfaction: a review of measuring instruments. Med Care Res Rev 52(1):109–133CrossRefPubMed
28.
go back to reference Von Keudell A, Sodha S, Collins J, Minas T, Fitz W, Gomoll A (2014) Patient satisfaction after primary total and unicompartmental knee arthroplasty: an age-dependent analysis. Knee 21(1):180–184CrossRef Von Keudell A, Sodha S, Collins J, Minas T, Fitz W, Gomoll A (2014) Patient satisfaction after primary total and unicompartmental knee arthroplasty: an age-dependent analysis. Knee 21(1):180–184CrossRef
29.
go back to reference Lee M, Huang Y, Chong HC, Ning Y, Lo NN, Yeo SJ (2016) Predicting satisfaction for unicompartmental knee arthroplasty patients in an Asian population. J Arthroplast 31(8):1706–1710CrossRef Lee M, Huang Y, Chong HC, Ning Y, Lo NN, Yeo SJ (2016) Predicting satisfaction for unicompartmental knee arthroplasty patients in an Asian population. J Arthroplast 31(8):1706–1710CrossRef
30.
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. JBJS 87(5):999–1006CrossRef 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. JBJS 87(5):999–1006CrossRef
31.
go back to reference Niinimäki T, Eskelinen A, Mäkelä K, Ohtonen P, Puhto A-P, Remes V (2014) Unicompartmental knee arthroplasty survivorship is lower than TKA survivorship: a 27-year finnish registry study. Clin Orthop Relat Res 472 (5):1496–1501CrossRefPubMed Niinimäki T, Eskelinen A, Mäkelä K, Ohtonen P, Puhto A-P, Remes V (2014) Unicompartmental knee arthroplasty survivorship is lower than TKA survivorship: a 27-year finnish registry study. Clin Orthop Relat Res 472 (5):1496–1501CrossRefPubMed
32.
go back to reference van der List JP, Zuiderbaan HA, Pearle AD (2016) Why do medial unicompartmental knee arthroplasties fail today? J Arthroplast 31 (5):1016–1021CrossRef van der List JP, Zuiderbaan HA, Pearle AD (2016) Why do medial unicompartmental knee arthroplasties fail today? J Arthroplast 31 (5):1016–1021CrossRef
33.
go back to reference 35. Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplast 23 (2):159–163CrossRef 35. Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplast 23 (2):159–163CrossRef
34.
go back to reference 36. Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Groseth KL (2005) Early failure of minimally invasive unicompartmental knee arthroplasty is associated with obesity. Clin Orthop Relat Res 440:60–66CrossRef 36. Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Groseth KL (2005) Early failure of minimally invasive unicompartmental knee arthroplasty is associated with obesity. Clin Orthop Relat Res 440:60–66CrossRef
Metadata
Title
A novel preoperative scoring system for the indication of unicompartmental knee arthroplasty, as predictor of clinical outcome and satisfaction
Authors
Alexander Antoniadis
Dimitris Dimitriou
Jean Pierre Canciani
Naeder Helmy
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 1/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-3069-8

Other articles of this Issue 1/2019

Archives of Orthopaedic and Trauma Surgery 1/2019 Go to the issue