Oxford domed lateral unicompartmental knee arthroplasty.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 8. Arch Orthop Trauma Surg. 2022 Feb;142(2):301-314. doi: 10.1007/s00402-021-03827-x. Epub 2021 Feb 25. Revision indications for medial unicompartmental knee arthroplasty: a systematic review. Tay ML(1)(2), McGlashan SR(3), Monk AP(4)(5), Young SW(6)(7). Author information: (1)Department of Orthopaedic Surgery, North Shore Hospital, 124 Shakespeare Road, Takapuna, 0622, Auckland, New Zealand. m.tay@auckland.ac.nz. (2)Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand. m.tay@auckland.ac.nz. (3)Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand. (4)Department of Orthopaedic Surgery, Auckland City Hospital, 2 Park Road, Grafton, 1023, Auckland, New Zealand. (5)Auckland Bioengineering Institute, University of Auckland, 70 Symonds Street, Auckland, 1010, New Zealand. (6)Department of Orthopaedic Surgery, North Shore Hospital, 124 Shakespeare Road, Takapuna, 0622, Auckland, New Zealand. (7)Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, 28 Park Ave, 1023, Auckland, New Zealand. INTRODUCTION: Unicompartmental knee arthroplasty (UKA) has advantages over total knee arthroplasty including fewer complications and faster recovery; however, UKAs also have higher revision rates. Understanding reasons for UKA failure may, therefore, allow for optimized clinical outcomes. We aimed to identify failure modes for medial UKAs, and to examine differences by implant bearing, cement use and time. MATERIALS AND METHODS: A systematic review was conducted by searching MedLine, EMBASE, CINAHL and Cochrane databases from 2000 to 2020. Studies were selected if they included ≥ 250 participants, ≥ 10 failures and reported all failure modes of medial UKA performed for osteoarthritis (OA). RESULTS: A total of 24 cohort and 2 registry-based studies (levels II and III) were selected. The most common failure modes were aseptic loosening (24%) and OA progression (30%). Earliest failures ( 2 years to 5 years) were due to OA progression (33%), aseptic loosening (17%) and pain (21%); and late-term (> 10 years) failures were mostly due to OA progression (56%). Rates of failure from wear were higher with fixed-bearing prostheses (5% cf. 0.3%), whereas rates of bearing dislocations were higher with mobile-bearing prostheses (14% cf. 0%). With cemented components, there was a high rate of failure due to aseptic loosening (27%), which was reduced with uncemented components (4%). CONCLUSIONS: UKA failure modes differ depending on implant design, cement use and time from surgery. There should be careful consideration of implant options and patient selection for UKA. © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature. DOI: 10.1007/s00402-021-03827-x