Dataset Information

Ten-Year Survivorship, Patient-Reported Outcomes, and Satisfaction of a Fixed-Bearing Unicompartmental Knee Arthroplasty.

ABSTRACT: Background:We sought to determine the 10-year survivorship and reasons for revision for a fixed-bearing unicompartmental knee arthroplasty (UKA) design. In addition, we report on patient-reported outcomes and satisfaction and compare results of medial vs lateral compartment UKA and cemented vs cementless UKA with the same design. Methods:We performed a retrospective cohort study on a single-surgeon case series using a single fixed-bearing UKA design in 158 consecutive patients who underwent 177 UKA procedures between July 2000 and December 2010. Cases missing follow-up within the last year, clinically or via telephone, were excluded (n = 17, 10%). A cumulative incidence competing risk model was used to evaluate the cumulative incidence of failure. Results:Cumulative incidence of revision at a mean follow-up of 10 years was 13%. The majority of revisions (43%, 10/23) were for aseptic tibial component loosening, followed by progression of osteoarthritis (5/23, 22%). All Patient Reported Outcomes Measurement Information System measures demonstrated mean T-scores within one standard deviation from the US population norm. The mean Knee Injury and Osteoarthritis Outcome Score for Joint Replacement was 96.9 (range, 40-100). The mean pain score was 3.8 (range, 0-8). Eighty-six percent of patients were satisfied with the UKA. Conclusions:At 10-year follow-up, the most common causes for revision were aseptic tibial loosening and adjacent compartment knee arthroplasty, and similar results were found for medial vs lateral compartment and for cemented vs cementless UKA. Surgeons should consider these findings for future UKA designs, and this represents the first study reporting on survivorship and outcomes of this specific UKA design.

SUBMITTER: Kagan R

PROVIDER: S-EPMC7303483 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Ten-Year Survivorship, Patient-Reported Outcomes, and Satisfaction of a Fixed-Bearing Unicompartmental Knee Arthroplasty.

Kagan Ryland R Anderson Mike B MB Bailey Travis T Hofmann Aaron A AA Pelt Christopher E CE

Arthroplasty today 20200406 2

<h4>Background</h4>We sought to determine the 10-year survivorship and reasons for revision for a fixed-bearing unicompartmental knee arthroplasty (UKA) design. In addition, we report on patient-reported outcomes and satisfaction and compare results of medial vs lateral compartment UKA and cemented vs cementless UKA with the same design.<h4>Methods</h4>We performed a retrospective cohort study on a single-surgeon case series using a single fixed-bearing UKA design in 158 consecutive patients who ...[more]

PMID: 32577476

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Project description:Background/objectiveAccording to previous studies, physiological gait pattern was found in unicompartmental knee arthroplasty (UKA) as compared to total knee arthroplasty (TKA) concerning the gait parameters including gait speed, cadence, and step length. However, little attention had been paid to the detailed kinematic and kinetic differences during gait between TKAs and UKAs. The aim of the present study was to investigate and to clarify the biomechanical differences between posterior stabilized TKAs and fixed bearing UKAs during walking.MethodsA total of 28 patients participated in the present study. Fifteen patients who underwent TKA and thirteen patients who underwent UKA were enrolled. Gait analysis was done at an average of 12.9 months after surgery. The subjects performed level walking at a preferred speed. For each subject, three-dimensional kinematic, kinetic and ground reaction force data were recorded as well as clinical data including range of motion at the knee joint and plain radiographs. Differences of knee kinematics or kinetics were compared between TKAs and UKAs using two-tailed Mann Whitney U-test.ResultsOn physical examination, passive range motion was significantly smaller in TKAs than in UKAs, while femorotibial angle on plain radiographs was not significantly different on plain radiographs. In terms of kinematics, TKAs were more flexed at heel contact and less extended in mid-stance phase compared to UKAs in the sagittal plane, and total excursion of TKAs were also smaller than UKAs. Regarding knee kinetics, TKA patients had significantly less peak tibial internal rotation moment in terminal stance phase. In addition, peak knee adduction moment was significantly larger in UKAs than in TKAs, while peak knee flexion moment was not significantly different.ConclusionPosterior stabilized TKAs exhibited less peak tibial internal rotation moment, which is known as pivot shift avoidance gait, in the present study, compared to fixed bearing UKAs. TKAs had similar gait pattern to anterior cruciate ligament deficient knees, compared to UKAs even if patients with TKAs had no subjective pain during walking.

Project description:BackgroundMore personalized implant designs for total knee arthroplasty might optimize the clinical outcome after surgery. One of these personalized implant designs is the Persona knee implant system (Zimmer Biomet, Warsaw, Indiana, USA). The primary objective of this study was to determine patient reported outcomes and implant survivorship of the Persona Knee system used in primary total knee arthroplasty, up to two years after surgery.MethodsFrom November 2013 to July 2016 consecutive patients undergoing primary total knee arthroplasty were enrolled in a prospective observational cohort study at three centers. Preoperatively, at 6 weeks, 6 months, 1 and 2 years after surgery, patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Oxford Knee Score (OKS), the Knee Society Score (KSS, 2011, modified version) and the EQ-5D. Adverse Events were captured, assessed for relationship to device, and recorded in the study database. Furthermore, physical functioning was assessed by the orthopedic surgeon. Repeated measures analyses were performed on PROM scores. Kaplan Meier was used to calculate survivorship of the Persona Knee Implant System.ResultsA total of 146 total knee arthroplasties were performed. 61% (89/146) of the patients were female and mean age was 64.7 (± 6.9) years. Two years after surgery, one patient had a revision of the polyethylene insert because of a periprosthetic joint infection. Therefore, the Kaplan-Meier survival estimate at 2 years was 0.99 (0.95-1.00 95% CI). OKS increased from 22.1 (95% CI 20.9-23.3) to 41.8 (95% CI 40.6-43.1) two years after surgery. Furthermore, all other PROMs also increased from before surgery to 2 year postoperatively.ConclusionThe Persona Knee implant is safe and effective and the clinical results up to two years after surgery are promising. PROMs results are very good; pain, function and quality of life all improved greatly after TKA. Further studies are needed to determine the long term clinical performance of the Persona prosthesis.Trial registrationClinicaltrials.gov ( NCT02337244 ). Registered June 1st, 2015. Retrospectively registered.

Dataset Information

Ten-Year Survivorship, Patient-Reported Outcomes, and Satisfaction of a Fixed-Bearing Unicompartmental Knee Arthroplasty.

Publications

Ten-Year Survivorship, Patient-Reported Outcomes, and Satisfaction of a Fixed-Bearing Unicompartmental Knee Arthroplasty.

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