The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement
<h4>Aims</h4> <p>An evidence based radiographic Decision Aid for meniscal-bearing unicompartmental knee replacement (UKR) has been developed and this study investigates its performance at an independent centre.</p> <h4>Patients and Methods</h4> <p>Pre-operat...
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| Format: | Journal article |
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British Editorial Society of Bone and Joint Surgery
2016
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| _version_ | 1797082655941984256 |
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| author | Hamilton, T Pandit, H Lombardi, A Adams, J Oosthuizen, C Clave, A Dodd, C Berend, K Murray, D |
| author_facet | Hamilton, T Pandit, H Lombardi, A Adams, J Oosthuizen, C Clave, A Dodd, C Berend, K Murray, D |
| author_sort | Hamilton, T |
| collection | OXFORD |
| description | <h4>Aims</h4> <p>An evidence based radiographic Decision Aid for meniscal-bearing unicompartmental knee replacement (UKR) has been developed and this study investigates its performance at an independent centre.</p> <h4>Patients and Methods</h4> <p>Pre-operative radiographs, including stress views, from a consecutive cohort of 550 knees undergoing replacement (UKR or TKR) by a single-surgeon were assessed. Suitability for UKR was determined using the Decision Aid with the assessor blinded to treatment received.</p> <h4>Results</h4> <p>The sensitivity and specificity of the Decision Aid was 92% and 88% respectively. Excluding knees where a clear pre-operative plan was made to perform TKR, i.e. patient request, the sensitivity was 93% and specificity 96%. The false-positive rate was low (2.3%) with all readily identifiable during joint inspection at surgery.</p> <br/> <p>In patients meeting Decision Aid criteria and receiving UKR the 5-year survival was 99% (95%CI 97 to 100%). The false-negatives (3.3%), who received UKR, but did not meet criteria, had significantly worse functional outcomes (flexion (p<0.001), AKSS-Functional (p<0.001), UCLA (p=0.04)), and lower implant survival 93.1% (95%CI 77.6 – 100%).</p> <h4>Conclusion</h4> <p>The radiographic Decision Aid safely and reliably identifies appropriate patients for meniscal-bearing UKR and achieves good results in this population. The widespread use of the Decision Aid should improve the results of UKR.</p> |
| first_indexed | 2024-03-07T01:30:50Z |
| format | Journal article |
| id | oxford-uuid:93891c2d-3fb1-4f4c-9646-6912a33c1f61 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T01:30:50Z |
| publishDate | 2016 |
| publisher | British Editorial Society of Bone and Joint Surgery |
| record_format | dspace |
| spelling | oxford-uuid:93891c2d-3fb1-4f4c-9646-6912a33c1f612022-03-26T23:33:02ZThe development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacementJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:93891c2d-3fb1-4f4c-9646-6912a33c1f61Symplectic Elements at OxfordBritish Editorial Society of Bone and Joint Surgery2016Hamilton, TPandit, HLombardi, AAdams, JOosthuizen, CClave, ADodd, CBerend, KMurray, D<h4>Aims</h4> <p>An evidence based radiographic Decision Aid for meniscal-bearing unicompartmental knee replacement (UKR) has been developed and this study investigates its performance at an independent centre.</p> <h4>Patients and Methods</h4> <p>Pre-operative radiographs, including stress views, from a consecutive cohort of 550 knees undergoing replacement (UKR or TKR) by a single-surgeon were assessed. Suitability for UKR was determined using the Decision Aid with the assessor blinded to treatment received.</p> <h4>Results</h4> <p>The sensitivity and specificity of the Decision Aid was 92% and 88% respectively. Excluding knees where a clear pre-operative plan was made to perform TKR, i.e. patient request, the sensitivity was 93% and specificity 96%. The false-positive rate was low (2.3%) with all readily identifiable during joint inspection at surgery.</p> <br/> <p>In patients meeting Decision Aid criteria and receiving UKR the 5-year survival was 99% (95%CI 97 to 100%). The false-negatives (3.3%), who received UKR, but did not meet criteria, had significantly worse functional outcomes (flexion (p<0.001), AKSS-Functional (p<0.001), UCLA (p=0.04)), and lower implant survival 93.1% (95%CI 77.6 – 100%).</p> <h4>Conclusion</h4> <p>The radiographic Decision Aid safely and reliably identifies appropriate patients for meniscal-bearing UKR and achieves good results in this population. The widespread use of the Decision Aid should improve the results of UKR.</p> |
| spellingShingle | Hamilton, T Pandit, H Lombardi, A Adams, J Oosthuizen, C Clave, A Dodd, C Berend, K Murray, D The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title | The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title_full | The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title_fullStr | The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title_full_unstemmed | The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title_short | The development and validation of a radiological Decision Aid to determine suitability for medial unicompartmental knee replacement |
| title_sort | development and validation of a radiological decision aid to determine suitability for medial unicompartmental knee replacement |
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