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Archives of Orthopaedic and Trauma Surgery

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10-08-2023 | Periprosthetic Fracture | Orthopaedic Surgery

Hinge prostheses in the revision of unicompartmental knee replacement: a descriptive analysis of data from the national joint registry for England, Wales and Northern Ireland

Authors: Tom Appleyard, Peter Avery, Paul Baker, Nick D. Clement, James Mason, David J. Deehan

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2024

Abstract

Introduction

Unicompartmental knee replacement (UKR) is an effective surgical strategy in patients with isolated medial or lateral compartment osteoarthritis. Study aims were to (1) describe the epidemiology of patients undergoing revision of UKR to a hinge knee replacement (HKR); (2) identify factors influencing time to revision; (3) evaluate HKR survival.

Materials and methods

An analysis of National Joint Registry data was undertaken, exploring revision of UKR to HKR between 2007 and April 2021. Descriptive analysis of eligible patients and Cox Regression to identify key determinants of time to revision were performed. Failure of HKR post-revision was assessed using survival analysis.

Results

111 patients underwent revision of UKR to HKR. Median age at revision was 70 years and most common indications were instability (n = 42) and infection (n = 22). The most common implant was a rotating HKR. Significant independent factors associated with earlier revision were periprosthetic fracture (p = 0.03) and malalignment (p = 0.03). Progressive osteoarthritis (p = 0.01) and higher ASA grades (3: p = 0.01, 4: p < 0.01) delayed time to revision; patient sex and age were not significant factors. Ten patients required subsequent re-revision; median age at re-revision was 61 years. HKR revised from UKR had an 89.3% revision-free risk at 5 years. Male sex (p < 0.01) and younger age (p < 0.01) were associated with re-revision.

Conclusions

Factors associated with time to revision may be used to counsel patients prior to UKR. The survivorship of the HKR of 89.3% at 5 years is concerning and careful consideration should be given when using this level of constraint when revising UKR in younger or male patients.

Available only for authorised users

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Title: Hinge prostheses in the revision of unicompartmental knee replacement: a descriptive analysis of data from the national joint registry for England, Wales and Northern Ireland
Authors: Tom Appleyard
Peter Avery
Paul Baker
Nick D. Clement
James Mason
David J. Deehan
Publication date: 10-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Periprosthetic Fracture
Knee-TEP
Knee-TEP
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-05010-w

2024 ASCO Annual Meeting

Springer Medicine

Hinge prostheses in the revision of unicompartmental knee replacement: a descriptive analysis of data from the national joint registry for England, Wales and Northern Ireland

Abstract

Introduction

Materials and methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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