Cemented mobile-bearing medial unicompartmental knee arthroplasty provides long-term implant survival and sustained functional performance in young and active patients aged 60 or below

IF 5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-05-26 DOI:10.1002/ksa.12703

Kevin-Arno Koch, Michael Thapa, Johannes Weishorn, Mustafa Hariri, Benedict Lotz, Kevin Knappe, Tobias Reiner, Tilman Walker

{"title":"Cemented mobile-bearing medial unicompartmental knee arthroplasty provides long-term implant survival and sustained functional performance in young and active patients aged 60 or below","authors":"Kevin-Arno Koch, Michael Thapa, Johannes Weishorn, Mustafa Hariri, Benedict Lotz, Kevin Knappe, Tobias Reiner, Tilman Walker","doi":"10.1002/ksa.12703","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>To evaluate long-term outcomes of cemented, mobile-bearing medial unicompartmental knee arthroplasty (UKA) in patients aged 60 or younger, focusing on implant survival, functional results, patient-reported outcome measures (PROMs), and radiographic findings over >10 years.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective single-centre study included 119 knees (102 patients). Implant survival was evaluated using Kaplan–Meier analysis. PROMs included the Oxford Knee Score (OKS), American Knee Society Score (AKSS), UCLA Activity Score and Visual Analogue Scale (VAS). Assessments were performed preoperatively, at mid-term (2–10 years), and at long-term follow-up (>10 years). OKS and AKSS were analysed in relation to Patient Acceptable Symptom State (PASS) thresholds. Radiographs were graded using the Kellgren–Lawrence classification to evaluate lateral osteoarthritis (LOA) progression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The implant survival rate was 86.7% (95% CI: 78.5–91.9%) at 15 years, and 81.7% (95% CI: 71.4%–88.5%) at 17.5 years. Revision surgery was required in 18 knees (mean time to revision: 8.7 years), primarily due to progression of LOA. All PROMs improved significantly from baseline to the final follow-up (mean: 16 years; <i>p</i> < 0.0001). Although minor functional declines occurred between mid- and long-term follow-ups, these were not statistically significant (<i>p</i> > 0.05), except for functional AKSS. At the final assessment, 96% of patients exceeded the PASS threshold for OKS, 84% for AKSS objective, and 80% for AKSS functional scores. Radiographic LOA progression was frequent but did not significantly impair functional outcomes.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Cemented mobile-bearing medial UKA in patients aged ≤60 years demonstrated high long-term implant survival and sustained functional benefit. Even in the presence of radiographic LOA progression, clinical outcomes remained excellent. UKA represents a durable and effective treatment for younger patients with isolated medial compartment osteoarthritis.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level IV.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3324-3332"},"PeriodicalIF":5.0000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12703","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12703","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To evaluate long-term outcomes of cemented, mobile-bearing medial unicompartmental knee arthroplasty (UKA) in patients aged 60 or younger, focusing on implant survival, functional results, patient-reported outcome measures (PROMs), and radiographic findings over >10 years.

Methods

This retrospective single-centre study included 119 knees (102 patients). Implant survival was evaluated using Kaplan–Meier analysis. PROMs included the Oxford Knee Score (OKS), American Knee Society Score (AKSS), UCLA Activity Score and Visual Analogue Scale (VAS). Assessments were performed preoperatively, at mid-term (2–10 years), and at long-term follow-up (>10 years). OKS and AKSS were analysed in relation to Patient Acceptable Symptom State (PASS) thresholds. Radiographs were graded using the Kellgren–Lawrence classification to evaluate lateral osteoarthritis (LOA) progression.

Results

The implant survival rate was 86.7% (95% CI: 78.5–91.9%) at 15 years, and 81.7% (95% CI: 71.4%–88.5%) at 17.5 years. Revision surgery was required in 18 knees (mean time to revision: 8.7 years), primarily due to progression of LOA. All PROMs improved significantly from baseline to the final follow-up (mean: 16 years; p < 0.0001). Although minor functional declines occurred between mid- and long-term follow-ups, these were not statistically significant (p > 0.05), except for functional AKSS. At the final assessment, 96% of patients exceeded the PASS threshold for OKS, 84% for AKSS objective, and 80% for AKSS functional scores. Radiographic LOA progression was frequent but did not significantly impair functional outcomes.

Conclusions

Cemented mobile-bearing medial UKA in patients aged ≤60 years demonstrated high long-term implant survival and sustained functional benefit. Even in the presence of radiographic LOA progression, clinical outcomes remained excellent. UKA represents a durable and effective treatment for younger patients with isolated medial compartment osteoarthritis.

Level of Evidence

Level IV.

Abstract Image

查看原文本刊更多论文

对于60岁或以下的年轻和活跃的患者，骨水泥移动承重内侧单室膝关节置换术可提供长期的植入物存活和持续的功能表现。

目的：评估60岁或以下患者行骨水泥、可移动承重的内侧单室膝关节置换术（UKA）的长期疗效，重点关注植入物存活、功能结果、患者报告的结果测量（PROMs）和10年以上的影像学表现。方法：本回顾性单中心研究纳入119个膝关节（102例）。采用Kaplan-Meier分析评估种植体存活。PROMs包括牛津膝关节评分（OKS）、美国膝关节协会评分（AKSS）、UCLA活动评分和视觉模拟量表（VAS）。术前、中期（2 ~ 10年）和长期随访（10 ~ 10年）进行评估。分析OKS和AKSS与患者可接受症状状态（PASS）阈值的关系。x线片采用Kellgren-Lawrence分级来评估侧位骨关节炎（LOA）的进展。结果：种植体15年生存率为86.7% (95% CI: 78.5 ~ 91.9%)， 17.5年生存率为81.7% （95% CI: 71.4% ~ 88.5%）。18例膝关节需要翻修手术（平均翻修时间：8.7年），主要是由于LOA进展。从基线到最终随访，所有prom均显著改善(平均：16年；p 0.05)，但功能性AKSS除外。在最终评估中，96%的患者超过了OKS的PASS阈值，84%的患者超过了AKSS目标评分，80%的患者超过了AKSS功能评分。影像学上LOA进展频繁，但没有显著损害功能预后。结论：在年龄≤60岁的患者中，骨水泥移动轴承内侧UKA具有较高的长期种植体存活率和持续的功能益处。即使在影像学上有LOA进展的情况下，临床结果仍然很好。UKA代表了一个持久和有效的治疗年轻患者孤立的内侧室骨关节炎。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).