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12.05.2017 | Original Article | Ausgabe 3/2017 Open Access

HSS Journal ® 3/2017

Mid-Term Outcomes of Metal-Backed Unicompartmental Knee Arthroplasty Show Superiority to All-Polyethylene Unicompartmental and Total Knee Arthroplasty

Zeitschrift:
HSS Journal ® > Ausgabe 3/2017
Autoren:
MD Jelle P. van der List, MD Laura J. Kleeblad, MD, PhD Hendrik A. Zuiderbaan, MD Andrew D. Pearle
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11420-017-9557-5) contains supplementary material, which is available to authorized users.
Level of Evidence: Level III: Therapeutic Study.

Abstract

Background

Two commonly used tibial designs for unicompartmental knee arthroplasty (UKA) are all-polyethylene “inlay” and metal-backed “onlay” components. Biomechanical studies showed that the metal baseplate in onlay designs better distributes forces over the tibia but studies failed to show differences in functional outcomes between both designs at mid-term follow-up. Furthermore, no studies have compared both designs with total knee arthroplasty (TKA).

Questions/Purposes

The goal of this study was to compare outcomes of inlay UKA and onlay UKA at mid-term follow-up and compare these with TKA outcomes.

Methods

In this retrospective study, 52 patients undergoing inlay medial UKA, 59 patients undergoing onlay medial UKA, and 59 patients undergoing TKA were included. Western Ontario and McMaster Universities Arthritis Index scores were collected preoperatively and at mean 5.1-year follow-up (range 4.0–7.0 years).

Results

Preoperatively, no differences were observed in patient characteristics or outcome scores. At mid-term follow-up, patients undergoing onlay medial UKA reported significant better functional outcomes than those of inlay medial UKA (92.0 ± 10.4 vs. 82.4 ± 18.7, p = 0.010) and when compared to TKA (92.0 ± 10.4 vs. 79.6 ± 18.5, p < 0.001) while no significant differences between inlay medial UKA and TKA were noted. No significant differences in revision rates were found.

Conclusion

Functional outcomes following onlay metal-backed medial UKA were significantly better compared to inlay all-polyethylene medial UKA and to TKA. Based on the results of this study and on biomechanical and survivorship studies in the literature, we recommended using metal-backed onlay tibial components for unicompartmental knee arthroplasty.

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Zusatzmaterial
ESM 1 (PDF 1224 kb)
11420_2017_9557_MOESM1_ESM.pdf
ESM 2 (PDF 1224 kb)
11420_2017_9557_MOESM2_ESM.pdf
ESM 3 (PDF 1224 kb)
11420_2017_9557_MOESM3_ESM.pdf
ESM 4 (PDF 1224 kb)
11420_2017_9557_MOESM4_ESM.pdf
Literatur
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