Cemented medial mobile-bearing Unicompartmental Knee Arthroplasty: Effects of compliance with current indications on functional outcomes and long-term survival rates
Luis Bernal-Fortich MD , Andrés Correa-Valderrama MD , Andres Echeverry-Vélez MD , Willy Stangl-Herrera MD , Erika Cantor MSc , Mónica Morales MSc , Julio César Palacio-Villegas
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引用次数: 0
Abstract
Background
Unicompartmental knee arthroplasty (UKA) is a surgical option for patients with medial compartment osteoarthritis (OA). The objective of this study was to describe the functional outcomes and long-term survival rates of cemented medial mobile-bearing UKA according to the compliance with current indications.
Methods
Retrospective study of 78 patients with medial unicompartimental knee OA treated with mobile-bearing cemented UKA (Oxford phase-III) between 2002 and 2012, with an average follow-up of 10.4 ± 3.4 years. Preoperative radiographs and clinical records were reviewed to assess the compliance with current indications (isolated medial compartment OA, flexion ≥ 90°, integrity of all ligaments, varus deformity<15°). Patients who met all criteria were classified with appropriate indication. The function was measured using the knee society score (KSS).
Results
Nineteen (24.3%) patients did not meet the current indications for UKA. Non-isolated OA of the medial compartment was the most frequent inappropriate indication (16 patients), followed by range of flexion<90° (2 patients) and lack of integrity of the ligaments (1 patient). A significant improvement was found on the KSS after surgery [preoperative KSS: 50.0 (Interquartile range-IQR: (35.0–60.0); postoperative KSS: 70.0 (IQR:60.0–70.0), p < 0.05]. Survival after 15 years of follow-up in cases without and with appropriate indication was 55.8% and 89.7%, respectively. A higher risk of revision surgery was found in cases with inappropriate indication (hazard ratio: 4.87, 95% Confidence Interval: 1.54–15.38, p:0.007).
Conclusion
When proper patient selection is carried out, cemented medial mobile-bearing UKA offers good functional outcomes with a survival rate of 89.7% at 15 years of follow-up.
期刊介绍:
Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.