Revision of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty: Is It as Good as a Primary Result?

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] 12. Knee Surg Sports Traumatol Arthrosc. 2023 Nov;31(11):4766-4772. doi: 10.1007/s00167-023-07483-z. Epub 2023 Jul 27. Patient-reported outcomes and satisfaction after revisions of medial unicompartmental knee arthroplasties for unexplained pain vs aseptic loosening. Arndt KB(1)(2), Schrøder HM(3)(4), Troelsen A(5), Lindberg-Larsen M(6)(7). Author information: (1)Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark. kristine.bollerup.arndt@rsyd.dk. (2)Department of Clinical Research, University of Southern Denmark, J. B. Winsløws Vej 4, 5000, Odense, Denmark. kristine.bollerup.arndt@rsyd.dk. (3)Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. (4)Department of Orthopaedic Surgery, Naestved Hospital. Naestved, Ringstedgade 61, 4700, Næstved, Denmark. (5)Departmentof Orthopaedic Surgery, Copenhagen University Hospital, Kettegård Alle 30, 2650, Hvidovre, Denmark. (6)Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark. (7)Department of Clinical Research, University of Southern Denmark, J. B. Winsløws Vej 4, 5000, Odense, Denmark. PURPOSE: Does patients revised for unexplained pain after mUKA present the same PROM and satisfaction scores 1-3 years after revision as patients revised for aseptic loosening?". METHODS: 104 patients undergoing revision of mUKA's for the indications unexplained pain and aseptic loosening were included in the period January 1, 2018 to December 31, 2020. from the Danish Knee Arthroplasty Register. 52 patients were revised for unexplained pain and 52 for aseptic loosening. Patient demographics did not differ between the two groups. PROMs [Oxford Knee Score (OKS), EQ-5D-5L, Forgotten Joint Score (FJS)] and questions about satisfaction with the surgery were sent to digitally secured mailboxes. Pearson's Chi-square test and Wilcoxon Rank Sum test were used to test for statistical differences between groups. RESULTS: The median OKS 1-3 years after revision was 26 (IQR 22) for unexplained pain vs 34 (IQR 12) for aseptic loosening, p = 0.033. The median EQ-5D-5L Index after revision was 0.7 (IQR 0.6) for unexplained vs 0.8 (IQR 0.1) for aseptic loosening, p = 0.014. The median FJS after revision was 48 (IQR 10) for unexplained pain vs 52 (IQR 14) for aseptic loosening, p = 0.1. The mean satisfaction with the surgery on a 0-100 scale (100 = not satisfied; 0 = very satisfied) was 55 (IQR 60) for unexplained pain vs 50 (IQR 67) for aseptic loosening, p = 0.087, and patients revised for unexplained pain were less likely to find their knee problem importantly improved (p = 0.032). CONCLUSION: Patients undergoing revision of mUKAs for unexplained pain presented poor postoperative PROM scores, and PROM scores were worse compared to those of patients revised for aseptic loosening. Patients revised for unexplained pain were less likely to find their knee problem importantly improved. This study support the evidence against revisions for unexplained pain. LEVEL OF EVIDENCE: Level III. © 2023. The Author(s). DOI: 10.1007/s00167-023-07483-z PMCID: PMC10598095