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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2016

25.10.2014 | Knee

Is isolated insert exchange a valuable choice for polyethylene wear in metal-backed unicompartmental knee arthroplasty?

verfasst von: Alexandre Lunebourg, Sébastien Parratte, Alexandre Galland, François Lecuire, Matthieu Ollivier, Jean-Noël Argenson

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2016

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Abstract

Purpose

The aim of this study was to evaluate the clinical outcome and survival rate after isolated liner exchange for polyethylene (PE) wear in well-fixed metal-backed fixed-bearing unicompartmental knee arthroplasty (UKA).

Methods

Twenty medial UKAs in 19 patients [mean age 68.7 years ± 8.7 (range 48.5–81.5 years)] operated on for a direct PE liner exchange after isolated PE wear between 1996 and 2010 in two institutions were retrospectively reviewed. The mean delay between the index operation and revision was 8.2 years ± 2.6 (range 4.8–12.8 years). A four-level satisfaction questionnaire was used, and clinical outcomes were assessed using Knee Society scores (KSS) and range of motion (ROM) evaluation. Radiological evaluation analysed the position of the implants and progression of the disease. Survival rate of the implants was evaluated using Kaplan–Meier analysis with two different end-points.

Results

At the last follow-up [mean 6.8 years ± 5.2 (range 1.1–15.9 years)], 15 patients (79 %) were enthusiastic or satisfied. KSS improved from 73.4 to 86.4 points (p = 0.01) and function from 58.9 to 89.2 points (p < 0.001). ROM at last FU was 126.5° ± 10.3°. The survival rate at 12 years considering “revision for any reason” as the end-point was 71.3 ± 15.3 %, and the survival rate at 12 years considering “revision of UKA to TKA” as the end-point was 93.3 ± 6.4 %.

Conclusion

Isolated liner exchange for PE wear in well-fixed metal-backed fixed-bearing UKA represents a valuable treatment option in selective patients with durable improvement of clinical outcomes without compromising any future revision.

Level of evidence

Retrospective therapeutic study, Level IV.
Literatur
1.
Zurück zum Zitat Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplast 23:159–163CrossRef Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplast 23:159–163CrossRef
2.
Zurück zum Zitat Argenson JN, Blanc G, Aubaniac JM, Parratte S (2013) Modern unicompartmental knee arthroplasty with cement: a concise follow-up, at a mean of twenty years, of a previous report. J Bone Jt Surg 95(10):905–909CrossRef Argenson JN, Blanc G, Aubaniac JM, Parratte S (2013) Modern unicompartmental knee arthroplasty with cement: a concise follow-up, at a mean of twenty years, of a previous report. J Bone Jt Surg 95(10):905–909CrossRef
3.
Zurück zum Zitat Argenson JN, Komistek RD, Aubaniac JM et al (2002) In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplast 17(8):1049–1054CrossRef Argenson JN, Komistek RD, Aubaniac JM et al (2002) In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplast 17(8):1049–1054CrossRef
4.
Zurück zum Zitat Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36PubMed Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36PubMed
5.
Zurück zum Zitat Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness and material stresses in ultra-high molecular weight components for total joint replacement. J Bone Jt Surg 68(7):1041–1051 Bartel DL, Bicknell VL, Wright TM (1986) The effect of conformity, thickness and material stresses in ultra-high molecular weight components for total joint replacement. J Bone Jt Surg 68(7):1041–1051
6.
Zurück zum Zitat Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Jt Surg 87(5):999–1006CrossRef Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Jt Surg 87(5):999–1006CrossRef
7.
Zurück zum Zitat Berger RA, Nedeff DD, Barden RM et al (1999) Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year follow-up. Clin Orthop 367:50–60CrossRefPubMed Berger RA, Nedeff DD, Barden RM et al (1999) Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year follow-up. Clin Orthop 367:50–60CrossRefPubMed
8.
Zurück zum Zitat Böhm I, Landsiedl F (2000) Revision surgery after failed unicompartmental knee arthroplasty: a study of 35 cases. J Arthroplast 15(8):982–989CrossRef Böhm I, Landsiedl F (2000) Revision surgery after failed unicompartmental knee arthroplasty: a study of 35 cases. J Arthroplast 15(8):982–989CrossRef
9.
Zurück zum Zitat Cameron HU, Jung YB (1988) A comparison of unicompartmental knee replacement with total knee replacement. Orthop Rev 17:983–988PubMed Cameron HU, Jung YB (1988) A comparison of unicompartmental knee replacement with total knee replacement. Orthop Rev 17:983–988PubMed
10.
Zurück zum Zitat Charnley J (1972) The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Jt Surg 54:61–76 Charnley J (1972) The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Jt Surg 54:61–76
11.
Zurück zum Zitat Châtain F, Richard A, Deschamps G, Chambat P, Neyret P (2004) Revision total knee arthroplasty after unicompartmental femorotibial prosthesis: 54 cases. Rev Chir Orthop Reparatrice Appar Mot 90(1):49–57CrossRefPubMed Châtain F, Richard A, Deschamps G, Chambat P, Neyret P (2004) Revision total knee arthroplasty after unicompartmental femorotibial prosthesis: 54 cases. Rev Chir Orthop Reparatrice Appar Mot 90(1):49–57CrossRefPubMed
12.
Zurück zum Zitat Chou DT, Swamy GN, Lewis JR, Badhe NP (2012) Revision of failed unicompartmental knee replacement to total knee replacement. Knee 19(4):356–359CrossRefPubMed Chou DT, Swamy GN, Lewis JR, Badhe NP (2012) Revision of failed unicompartmental knee replacement to total knee replacement. Knee 19(4):356–359CrossRefPubMed
13.
Zurück zum Zitat Collier MB, Engh CA, McAuley JP, Engh GA (2007) Factors associated with the loss of thickness of polyethylene tibial bearings after knee arthroplasty. J Bone Jt Surg 89(6):1306–1314CrossRef Collier MB, Engh CA, McAuley JP, Engh GA (2007) Factors associated with the loss of thickness of polyethylene tibial bearings after knee arthroplasty. J Bone Jt Surg 89(6):1306–1314CrossRef
14.
Zurück zum Zitat Diezi C, Wirth S, Meyer DC, Kock PP (2010) Effect of femoral to tibial varus mismatch on the contact area of unicondylar knee prostheses. Knee 17(5):350–355CrossRefPubMed Diezi C, Wirth S, Meyer DC, Kock PP (2010) Effect of femoral to tibial varus mismatch on the contact area of unicondylar knee prostheses. Knee 17(5):350–355CrossRefPubMed
15.
Zurück zum Zitat Emerson RH, Higgins LL (2008) Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Jt Surg 90(1):118–122CrossRef Emerson RH, Higgins LL (2008) Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Jt Surg 90(1):118–122CrossRef
16.
Zurück zum Zitat Felts E, Parratte S, Pauly V, Aubaniac JM, Argenson JN (2010) Function and quality of life following medial unicompartmental knee arthroplasty in patients 60 years of age or young. Orthop Traumatol Surg Res 96(8):861–867CrossRefPubMed Felts E, Parratte S, Pauly V, Aubaniac JM, Argenson JN (2010) Function and quality of life following medial unicompartmental knee arthroplasty in patients 60 years of age or young. Orthop Traumatol Surg Res 96(8):861–867CrossRefPubMed
18.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
19.
Zurück zum Zitat Johnson S, Jones P, Newman JH (2007) The survivorship and results of total knee replacements converted from unicompartmental knee replacements. Knee 14(2):154–157CrossRefPubMed Johnson S, Jones P, Newman JH (2007) The survivorship and results of total knee replacements converted from unicompartmental knee replacements. Knee 14(2):154–157CrossRefPubMed
20.
Zurück zum Zitat Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef
21.
Zurück zum Zitat Kennedy WR, White RP (1987) Unicompartmental arthroplasty of the knee: postoperative alignment and its influence on overall results. Clin Orthop Relat Res 221:278–285PubMed Kennedy WR, White RP (1987) Unicompartmental arthroplasty of the knee: postoperative alignment and its influence on overall results. Clin Orthop Relat Res 221:278–285PubMed
22.
Zurück zum Zitat Laurencin CT, Zelicof SB, Scott RD, Ewald FC (1991) Unicompartmental versus total knee arthroplasty in the same patient: a comparative study. Clin Orthop Relat Res 273:151–156PubMed Laurencin CT, Zelicof SB, Scott RD, Ewald FC (1991) Unicompartmental versus total knee arthroplasty in the same patient: a comparative study. Clin Orthop Relat Res 273:151–156PubMed
23.
Zurück zum Zitat Lecuire F, Galland A, Basso M, Vinel H, Rubini J (2013) Partial or total replacement of a unicompartmental knee prosthesis by another unicompartmental knee prosthesis: a reasonable option? About 22 cases. Eur J Orthop Surg Traumatol 23(8):933–938CrossRefPubMed Lecuire F, Galland A, Basso M, Vinel H, Rubini J (2013) Partial or total replacement of a unicompartmental knee prosthesis by another unicompartmental knee prosthesis: a reasonable option? About 22 cases. Eur J Orthop Surg Traumatol 23(8):933–938CrossRefPubMed
24.
Zurück zum Zitat Lingaraj K, Morris H, Bartlett J (2011) Polyethylene thickness in unicompartmental knee arthroplasty. Knee 18(3):165–167CrossRefPubMed Lingaraj K, Morris H, Bartlett J (2011) Polyethylene thickness in unicompartmental knee arthroplasty. Knee 18(3):165–167CrossRefPubMed
25.
Zurück zum Zitat McAuley JP, Engh GA, Ammeen DJ (2001) Revision of failed unicompartmental knee arthroplasty. Clin Orthop Relat Res 392:279–282CrossRefPubMed McAuley JP, Engh GA, Ammeen DJ (2001) Revision of failed unicompartmental knee arthroplasty. Clin Orthop Relat Res 392:279–282CrossRefPubMed
26.
Zurück zum Zitat Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement the 15-year results of a prospective randomised controlled trial. J Bone Jt Surg 91(1):52–57CrossRef Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement the 15-year results of a prospective randomised controlled trial. J Bone Jt Surg 91(1):52–57CrossRef
27.
Zurück zum Zitat Plante-Bordeneuve P, Freeman MA (1993) Tibial high-density polyethylene wear in conforming tibiofemoral prostheses. J Bone Jt Surg 75(4):630–636 Plante-Bordeneuve P, Freeman MA (1993) Tibial high-density polyethylene wear in conforming tibiofemoral prostheses. J Bone Jt Surg 75(4):630–636
28.
Zurück zum Zitat Riddle DL, Jiranek WA, McGlynn FJ (2008) Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplast 23(3):408–412CrossRef Riddle DL, Jiranek WA, McGlynn FJ (2008) Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplast 23(3):408–412CrossRef
29.
Zurück zum Zitat Rougraff BT, Heck DA, Gibson AE (1991) A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res 273:157–164PubMed Rougraff BT, Heck DA, Gibson AE (1991) A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res 273:157–164PubMed
30.
Zurück zum Zitat Saldanha KA, Keys GW, Svard UC, White SH, Rao C (2007) Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty—results of a multicentre study. Knee 14(4):275–279CrossRefPubMed Saldanha KA, Keys GW, Svard UC, White SH, Rao C (2007) Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty—results of a multicentre study. Knee 14(4):275–279CrossRefPubMed
31.
Zurück zum Zitat Sierra RJ, Kassel CA, Wetters NG et al (2013) Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk! J Arthroplast 28(Suppl. 1):128–132CrossRef Sierra RJ, Kassel CA, Wetters NG et al (2013) Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk! J Arthroplast 28(Suppl. 1):128–132CrossRef
32.
Zurück zum Zitat Springer BD, Scott RD, Thornhill TS (2006) Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res 446:214–220CrossRefPubMed Springer BD, Scott RD, Thornhill TS (2006) Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res 446:214–220CrossRefPubMed
33.
Zurück zum Zitat Tew M, Waugh W (1982) Estimating the survival time of knee replacement. J Bone Jt Surg 64:579–582 Tew M, Waugh W (1982) Estimating the survival time of knee replacement. J Bone Jt Surg 64:579–582
34.
Zurück zum Zitat Vince KG, Cyran LT (2004) Unicompartmental knee arthroplasty: new indications, more complications. J Arthroplast 19(4 Suppl 1):9–16CrossRef Vince KG, Cyran LT (2004) Unicompartmental knee arthroplasty: new indications, more complications. J Arthroplast 19(4 Suppl 1):9–16CrossRef
Metadaten
Titel
Is isolated insert exchange a valuable choice for polyethylene wear in metal-backed unicompartmental knee arthroplasty?
verfasst von
Alexandre Lunebourg
Sébastien Parratte
Alexandre Galland
François Lecuire
Matthieu Ollivier
Jean-Noël Argenson
Publikationsdatum
25.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2016
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3392-8

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