Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors
Purpose Fixed bearing (FB) UKA constituted 63.7% of unicondylar knee arthroplasties in 2020 Australian Registry with the longest UKA survivorship. The significance of patellofemoral joint (PFJ) arthritis, ACL deficiency, post-operative anteromedial pain, radiosclerosis or radiolucency on survivorshi...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-11-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/10225536221141782 |
| _version_ | 1811216828932816896 |
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| author | Qunn Jid Lee Wai Yee, Esther Chang Yiu Chung Wong |
| author_facet | Qunn Jid Lee Wai Yee, Esther Chang Yiu Chung Wong |
| author_sort | Qunn Jid Lee |
| collection | DOAJ |
| description | Purpose Fixed bearing (FB) UKA constituted 63.7% of unicondylar knee arthroplasties in 2020 Australian Registry with the longest UKA survivorship. The significance of patellofemoral joint (PFJ) arthritis, ACL deficiency, post-operative anteromedial pain, radiosclerosis or radiolucency on survivorship of FB UKA is not established. The aim of this study was to analyze the medium-term survivorship of fixed-bearing UKA with no exclusion of PFJ OA and ACL deficiency. Predictors for failure were analyzed. Methods FB UKA performed in 2011-17 were reviewed. Cases with PFJ OA or ACL deficiency were not excluded. The effect on survivorship by ACL deficiency, PFJ arthritis, post-operative anteromedial pain and radiological abnormalities were analyzed. Results There were 96 UKA with follow-up time of 66 ± 18 months (27–98). The mean age was 70 ± 9 years, BMI 25.8 ± 2.6 kg/m 2 . Alignment was varus 9° ± 4° pre-operatively and varus 3° ± 3° post-operatively. There were four revisions (4.2%) and 4 deaths (4.2%). Reasons for revisions were loosening ( n = 1), persistent pain ( n = 2) and lateral compartment disease ( n = 1). Estimated survival at 8.3 years was 94.7% (95% CI 91.6–97.7). BMI ≥30 was found to be a significant predictor for failure. The incidence of radiographic abnormalities was 75% for PFJ arthritis, 39% for tibial tray overhang, 14% for radiolucency or radiosclerosis, 5% for ACL deficiency and 5% for edge loading respectively but they were not significantly associated with lower survivorship or anteromedial knee pain. The presence of anteromedial pain after surgery in 36.5% was also not significantly associated with survivorship. Conclusion FB UKA with no exclusion of early PFJ arthritis and ACL deficiency has satisfactory medium-term survivorship. BMI ≥30 could have higher risk of all-cause revision. Tibial tray overhang, non-progressive radiolucency or radiosclerosis do not seem to be associated with anteromedial knee pain or poorer medium term survivorship. |
| first_indexed | 2024-04-12T06:44:39Z |
| format | Article |
| id | doaj.art-44f635ae7ba34e6ea287fc5829e959e1 |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-04-12T06:44:39Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-44f635ae7ba34e6ea287fc5829e959e12022-12-22T03:43:36ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902022-11-013010.1177/10225536221141782Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictorsQunn Jid LeeWai Yee, Esther ChangYiu Chung WongPurpose Fixed bearing (FB) UKA constituted 63.7% of unicondylar knee arthroplasties in 2020 Australian Registry with the longest UKA survivorship. The significance of patellofemoral joint (PFJ) arthritis, ACL deficiency, post-operative anteromedial pain, radiosclerosis or radiolucency on survivorship of FB UKA is not established. The aim of this study was to analyze the medium-term survivorship of fixed-bearing UKA with no exclusion of PFJ OA and ACL deficiency. Predictors for failure were analyzed. Methods FB UKA performed in 2011-17 were reviewed. Cases with PFJ OA or ACL deficiency were not excluded. The effect on survivorship by ACL deficiency, PFJ arthritis, post-operative anteromedial pain and radiological abnormalities were analyzed. Results There were 96 UKA with follow-up time of 66 ± 18 months (27–98). The mean age was 70 ± 9 years, BMI 25.8 ± 2.6 kg/m 2 . Alignment was varus 9° ± 4° pre-operatively and varus 3° ± 3° post-operatively. There were four revisions (4.2%) and 4 deaths (4.2%). Reasons for revisions were loosening ( n = 1), persistent pain ( n = 2) and lateral compartment disease ( n = 1). Estimated survival at 8.3 years was 94.7% (95% CI 91.6–97.7). BMI ≥30 was found to be a significant predictor for failure. The incidence of radiographic abnormalities was 75% for PFJ arthritis, 39% for tibial tray overhang, 14% for radiolucency or radiosclerosis, 5% for ACL deficiency and 5% for edge loading respectively but they were not significantly associated with lower survivorship or anteromedial knee pain. The presence of anteromedial pain after surgery in 36.5% was also not significantly associated with survivorship. Conclusion FB UKA with no exclusion of early PFJ arthritis and ACL deficiency has satisfactory medium-term survivorship. BMI ≥30 could have higher risk of all-cause revision. Tibial tray overhang, non-progressive radiolucency or radiosclerosis do not seem to be associated with anteromedial knee pain or poorer medium term survivorship.https://doi.org/10.1177/10225536221141782 |
| spellingShingle | Qunn Jid Lee Wai Yee, Esther Chang Yiu Chung Wong Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors Journal of Orthopaedic Surgery |
| title | Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors |
| title_full | Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors |
| title_fullStr | Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors |
| title_full_unstemmed | Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors |
| title_short | Mid-term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early PFJ arthritis or ACL deficiency: Analysis of clinical and radiological predictors |
| title_sort | mid term survivorship of fixed bearing unicondylar knee arthroplasty with no exclusion of early pfj arthritis or acl deficiency analysis of clinical and radiological predictors |
| url | https://doi.org/10.1177/10225536221141782 |
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