Mustafa Hariri, Jakob Freytag, Kevin-Arno Koch, Paul Mick, Timo Nees, Kevin Knappe, Tobias Renkawitz, Tilman Walker
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引用次数: 0
Abstract
Introduction
Failure of lateral unicompartmental knee replacement (UKR) with a mobile-bearing (MB) device often occurs due to bearing dislocation. The effectiveness of various treatment options for revision surgery is not clear. Therefore, the purpose of this study was to report on the failure modes in lateral MB-UKR, as well as the results of different revision strategies.
Materials and methods
Patients who experienced failure of lateral MB-UKR and required revision surgery at a single-center between 2008 and 2020 were included in this retrospective study. The aim of the study was to report the reasons for failure and to document all treatment strategies employed. Survivorship analysis was conducted using the Kaplan-Meier estimator, with the endpoint defined as ‘re-revision for any reason’. Survival rates among various treatment strategies were compared using the log-rank test.
Results
A total of 13 patients were included in the study, with a mean follow-up (FU) period of 94.7 ± 36.4 months. The reasons for failure included bearing dislocation in 69.2%, progression of osteoarthritis (OA) in 23.1%, and periprosthetic joint infection in 7.7%. Treatment options included replacement of the tibial component with a fixed-bearing (FB) device in 23.1% of cases, solitary exchange of the bearing in 53.8%, or conversion to an unconstrained total knee replacement (TKR) in 23.1%. The re-dislocation rate in patients who underwent a bearing exchange as a treatment for bearing dislocation was 100%, with a mean FU period of 8.4 ± 11 months. Therefore, survivorship for the treatment of bearing dislocation differed significantly in these patients compared to those who received an exchange to a FB device (0% vs. 100%, p = 0.014).
Conclusions
Addressing the recurring issue of bearing dislocation in lateral MB-UKR demands a more comprehensive approach than merely replacing the bearing. Effective solutions include replacing the tibial component with an FB design or converting to an unconstrained TKR.
期刊介绍：
"Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance.
"Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).
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