Unicompartmental Knee Arthroplasty: Short-Term Results

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Abstract

Background. Among the methods of surgical treatment of early stages medial knee osteoarthritis in the partial knee replacement (PKR) becomes more and more relevant. The relevance and increasing number of PKR are confirmed by data from various national registers.

The aim of the study was to research the early functional results of PKR and to analyze the complications at various stages of the postoperative period.

Material and Methods. Study design: a single-center prospective study. The results of 90 operations of PKR in the period from March 2018 to April 2020 are presented. Assessment of knee function and quality of life of patients was performed according to three scalesquestionnaires: KOOS, WOMAC, SF-36, which were filled in preoperatively and then at 3, 6, 9, 12, 18 months. after surgery. Patients within the reporting period provided X-rays and filled in the scales at the face-to-face examination and at remote contact.

Results. The most significant improvement of quality of life and median values of the functional results observed after 3 months, and after 18 months. After replacement the best median functional outcome scales KOOS, WOMAC, SF-36 — 79,4 (73,6–84,3); 27,1 (24,8–30,6); 89,1 (85,3–92,6) compared with the functional results obtained before surgery 32,3 (22,8–38,4); 73,6 (63,6–78,8); 35,2 (31,3–42,1); p = 0,027; p = 0.023; p = 0,028, respectively. A negative correlation was obtained between BMI and functional outcome (p = 0.027, R = -0.7).

Conclusion. PKR allowed us to achieve an improvement in the quality of life and functional results already in the early postoperative period (from 3 to 18 months after the operation). The improvement of the operating technique, the analysis of errors and the regularity of the performed PKR will improve the results of PKR and minimize the number of complications.

About the authors

V. Yu. Murylev

Sechenov First Moscow State Medical University (Sechenov University); Botkin City Clinical Hospital

Author for correspondence.
Email: nmuril@yandex.ru
ORCID iD: 0000-0001-5753-8926

Valeriy Yu. Murylev — Dr. Sci. (Med.), Professor

Moscow

Россия

N. E. Erokhin

Sechenov First Moscow State Medical University (Sechenov University); Botkin City Clinical Hospital

Email: nik_erokhin@mail.ru

Nikolay E. Erokhin — PhD Student

Moscow

Россия

P. M. Elizarov

Sechenov First Moscow State Medical University (Sechenov University); Botkin City Clinical Hospital

Email: elizarov_07@mail.ru

Pavel M. Elizarov – Cand. Sci. (Med.), Assistant Professor; Orthopedic Surgeon

Moscow

Россия

G. A. Kukovenko

Sechenov First Moscow State Medical University (Sechenov University); Botkin City Clinical Hospital

Email: gkukovenko@gmail.com
ORCID iD: 0000-0001-6700-0222

Grigory A. Kukovenko — Lecturer; Orthopedic Surgeon

Moscow

Россия

A. V. Muzychenkov

Sechenov First Moscow State Medical University (Sechenov University); Botkin City Clinical Hospital

Email: battle-hamster@mail.ru

Aleksey V. Muzychenkov – Junior Lecturer; Orthopedic Surgeon

Moscow

S. S. Alekseev

Botkin City Clinical Hospital

Email: semen.alekseev.92@mail.ru

Semen S. Alekseev — Orthopedic Surgeon

Moscow

Россия

L. R. Ivanenko

Sechenov First Moscow State Medical University (Sechenov University)

Email: uchenichok@gmail.com

Leonid R. Ivanenko — PhD Student

Moscow

Россия

References

  1. Louise Murphy, Todd A. Schwartz, Charles G. Helmick, Jordan B. Renner, Gail Tudor, Gary Koch, Anca Dragomir, William D. Kalsbeek, Gheorghe Luta, and Joanne M. Jordan. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008 Sep 15; 59(9): 1207–1213. doi: 10.1002/art.24021.
  2. Cao Z, Mai X, Wang J, Feng E, Huang Y. Unicompartmental Knee Arthroplasty vs High Tibial Osteotomy for Knee Osteoarthritis: A Systematic Review and Meta-Analysis. J Arthroplasty. 2018;33(3):952‐959. doi: 10.1016/j.arth.2017.10.025.
  3. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2019 Annual Report. Adelaide: AOA, 2019. ISSN 1445-3657.
  4. Sikorski JM, Sikorska JZ. Relative risk of different operations for medial compartment osteoarthritis of the knee. Orthopedics. 2011 Dec 6;34(12):e847-54. doi: 10.3928/01477447-20111021-04.
  5. Robertsson, Otto & Lidgren, Lars & Sundberg, Martin & W-Dahl, Annette. (2020). The Swedish Knee Arthroplasty Register - Annual report 2019. ISBN 978-91-88017-29-1.
  6. The New Zealand Joint Registry. Annual Report 2019. NZOA, 2020.
  7. Fisher, N., Agarwal, M., Reuben, S.F., Johnson, D.S., and Turner, P.G. Sporting and physical activity following Oxford medial unicompartmental knee arthroplasty. Knee. 2016; 13: 296–300. doi: 10.1016/j.knee.2006.03.004.
  8. Walker T, Streit J, Gotterbarm T, Bruckner T, Merle C, Streit MR. Sports, physical activity and patient-reported outcomes after medial unicompartmental knee arthroplasty in young patients. J Arthroplasty. 2015;30:1911–6. doi: 10.1016/j.arth.2015.05.031.
  9. Hamilton T, Pandit H, Jenkins C, Mellon S, Dodd C, Murray D, Evidencebased indications for mobile-bearing unicompartmental knee replacement in a consecutive cohort of 1000 knees, The Journal of Arthroplasty (2017), doi: 10.1016/j.arth.2016.12.036.
  10. Nettrour JF, Ellis RT, Hansen BJ, Keeney JA. High Failure Rates for Unicompartmental Knee Arthroplasty in Morbidly Obese Patients: A Two-Year Minimum Follow-Up Study. J Arthroplasty. 2020;35(4):989‐996. doi: 10.1016/j.arth.2019.11.003.
  11. Hansen EN, Ong KL, Lau E, Kurtz SM, Lonner JH. Unicondylar Knee Arthroplasty Has Fewer Complications but Higher Revision Rates Than Total Knee Arthroplasty in a Study of Large United States Databases. J Arthroplasty. 2019;34(8):1617‐1625. doi: 10.1016/j.arth.2019.04.004.
  12. Hollinghurst, D., Stoney, J., and Ward, T. No deterioration of kinematics and cruciate function 10 years after medial unicompartmental arthroplasty. Knee. 2006; 13: 440–444. doi: 10.1016/j.knee.2006.07.001.
  13. Корнилов Н. Н., Куляба Т. А., Федоров Р. Э. Современные представления об одномыщелковом эндопротезировании в структуре хирургических методов лечения больных гонартрозом (обзор литературы). Травматология и ортопедия России. 2012; №1. doi: 10.21823/2311-2905-2012-0-1-138-144.
  14. Weale AE, Halabi OA, Jones PW, White SH. Perceptions of outcomes after unicompartmental and total knee replacements. Clin Orthop Relat Res. 2001 Jan;(382):143-53. PMID: 11153982.
  15. Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ. Unicompartmental Knee Arthroplasty vs Total Knee Arthroplasty for Medial Compartment Arthritis in Patients Older Than 75 Years: Comparable Reoperation, Revision, and Complication Rates. J Arthroplasty. 2017;32(6):1792‐1797. doi: 10.1016/j.arth.2017.01.020.
  16. Friesenbichler B, Item-Glatthorn JF, Wellauer V, von Knoch F, Casartelli NC, Maffiuletti NA. Short-term functional advantages after medial unicompartmental versus total knee arthroplasty. Knee. 2018;25(4):638‐643. doi: 10.1016/j.knee.2018.04.009.
  17. Zuo W, Ma J, Guo W, Zhang Q, Wang W, Liu Z. Comparison of the clinical outcomes of revision of failed UKAs to TKAs with primary TKAs: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Dec;97(50):e13408. doi: 10.1097/MD.0000000000013408.
  18. Casper DS, Fleischman AN, Papas PV, Grossman J, Scuderi GR, Lonner JH. Unicompartmental Knee Arthroplasty Provides Significantly Greater Improvement in Function than Total Knee Arthroplasty Despite Equivalent Satisfaction for Isolated Medial Compartment Osteoarthritis. J Arthroplasty. 2019;34(8):1611‐1616. doi: 10.1016/j.arth.2019.04.005.
  19. Walker T, Hetto P, Bruckner T, et al. Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term. Knee Surg Sports Traumatol Arthrosc. 2019;27(5):1658‐1664. doi: 10.1007/s00167-018-5299-2.
  20. Banks, S.A., Fregly, B.J., Boniforti, F., Reinschmidt, C., and Romagnoli, S. Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc. 2005; 13: 551–556. DOI: 10,1007 / s00167-004-0565-х.
  21. Фирсов С.А., Гагарин В.В. Анализ ранних результатов одномыщелкового эндопротезирования коленного сустава. Травматология и ортопедия России. 2015; (2):99-105.
  22. Moo-Ho Song, Bu-Hwan Kim, Seong-Jun Ahn, Seong-Ho Yoo, Min-Soo Lee. Early Complications After Minimally Invasive Mobile-Bearing Medial Unicompartmental Knee Arthroplasty. The Journal of Arthroplasty Vol. 24 No. 8, 2009. doi: 10.1016/j.arth.2009.07.012.
  23. Корнилов Н.Н., Куляба Т.А., Федоров Р.Э. Причины повторных хирургических вмешательств после одномыщелкового эндопротезирования коленного сустава. Травматология и ортопедия России. 2013;(1):12-18. doi: 10.21823/2311-2905-2013--1-12-18.
  24. Murray DW, Liddle AD, Dodd CA, Pandit H. Unicompartmental knee arthroplasty: is the glass half full or half empty? [published correction appears in Bone Joint J. 2015 Dec;97-B(12):1732. Liddle, A [corrected to Liddle, A D]]. Bone Joint J. 2015;97-B(10 Suppl A):3‐8. doi: 10.1302/0301-620X.97B10.36542.
  25. Vasso M., Antoniadis A., Helmy N. Update on unicompartmental knee arthroplasty. Current indications and failure modes. EFORT Open Rev. 2018 Aug; 3(8): 442–448. Published online 2018 Aug 1. doi: 10.1302/2058-5241.3.170060.
  26. Kim YJ, Kim BH, Yoo SH, Kang SW, Kwack CH, Song MH. Mid-term results of oxford medial unicompartmental knee arthroplasty in young asian patients less than 60 years of age: a minimum 5-year follow-up. Knee Surg Relat Res. 2017;29:122–8. doi: 10.5792/ksrr.16.045.
  27. Xu T, Lao Y, Wang J, Liu F, Xiao L, Tong P. Mid-term results of Oxford phase-3 medial unicompartmental knee arthroplasty for medial arthritis in Chinese patients. Epub 2016 Sep 27. doi: 10.1111/ans.13764.
  28. Koshino T, Sato K, Umemoto Y, et al. Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation. Int Orthop 2015; 39(6):1085-1091. doi: 10.1007/s00264-014-2564-y.
  29. Vasso M, Del Regno C, Perisano C, et al. Unicompartmental knee arthroplasty is effective: ten year results. Int Orthop 2015;39(12):2341-2346. doi: 10.1007/s00264-015-2809-4.
  30. Yoshida K, Tada M, Yoshida H, et al. Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 2013;28(9)(suppl):168-171. doi: 10.1016/j.arth.2013.08.019.
  31. Ollivier M, Jacquet C, Lucet A, Parratte S, Argenson JN. Long-Term Results of Medial Unicompartmental Knee Arthroplasty for Knee Avascular Necrosis. J Arthroplasty. 2019 Mar;34(3):465-468. Epub 2018 Nov 12. . doi: 10.1016/j.arth.2018.11.010.
  32. Kyung Tae Kim, Song Lee, Jung Soo Lee, Min Su Kang, and Ki Hyuk Koo. Long-Term Clinical Results of Unicompartmental Knee Arthroplasty in Patients Younger than 60 Years of Age: Minimum 10-Year Follow-up. Knee Surg Relat Res. 2018 Mar; 30(1): 28–33. Published online 2018 Mar 1. doi: 10.5792/ksrr.17.025.
  33. Crawford DA, Adams JB, Lombardi AV Jr, Berend KR. Activity Level Does Not Affect Survivorship of Unicondylar Knee Arthroplasty at 5-Year Minimum Follow-Up. J Arthroplasty. 2019;34(7):1364‐1368. doi: 10.1016/j.arth.2019.03.038.
  34. Harris, W.H. Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res. 2001, Dec;(393):66-70. doi: 10.1097/00003086-200112000-00007.
  35. Kendrick, B.J., Simpson, D.J., Kaptein, B.L., Valstar, E.R., Gill, H.S., Murray, D.W. et al. Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years. J Bone Joint Surg Br. 2011; 93: 470–475. doi: 10.1302/0301-620X.93B4.
  36. Peskun C, Walmsley D, Waddell J, Schemitsch E. Effect of surgeon fatigue on hip and knee arthroplasty. Can J Surg. 2012 Apr;55(2):81-6. doi: 10.1503/cjs.032910. PMID: 22269219; PMCID: PMC3310761.
  37. Kelz RR, Freeman KM, Hosokawa PW, Asch DA, Spitz FR, Moskowitz M, Henderson WG, Mitchell ME, Itani KM. Time of day is associated with postoperative morbidity: an analysis of the national surgical quality improvement program data. Ann Surg. 2008 Mar;247(3):544-52. doi: 10.1097/SLA.0b013e31815d7434. PMID: 18376202.

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