Outcome of revision UKR to TKR when compared to a matched group of TKR of same total arthroplasty lifespan.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 15 03 2017
revised: 04 11 2018
accepted: 14 12 2018
pubmed: 23 2 2019
medline: 16 7 2019
entrez: 23 2 2019
Statut: ppublish

Résumé

To compare outcomes of revision uni-compartmental knee replacement (UKR) with a defined revision cause with a matched group of primary total knee replacements (TKR). UKR accounts for 8.7% of knee arthroplasty in the UK each year. It has better functional outcome than total knee replacement for isolated single compartment arthritis but can result in complex surgery when revision is required. This is feared to result in poorer patient reported outcomes when compared to primary TKR. We aim to compare the clinical results of revised UKR with primary TKR, taking into account the survival length of the UKR. Forty-five patients (27 female) were retrospectively identified from our arthroplasty database that had undergone revision from UKR to TKR (1999-2014) and had a minimum of two years of follow-up post-revision. These patients were then matched with regards to age at primary procedure, sex, BMI and total arthroplasty life (UKR + Revision TKR) up to point of follow-up. In the UKR revision group (mean arthroplasty life 8.6 years) the mean Oxford knee score (OKS) was 31.8. In the primary knee group (mean arthroplasty life 8.4 years) the mean OKS was 32.8. This difference was not statistically significant. Fifteen out of 45 patients undergoing revision surgery required stemmed components. UKR provides comparable clinical outcome even after revision surgery to TKR as primary TKRs and should be considered in all patients meeting the selection criteria. Revision is complex and revision components should be available.

Sections du résumé

AIM OBJECTIVE
To compare outcomes of revision uni-compartmental knee replacement (UKR) with a defined revision cause with a matched group of primary total knee replacements (TKR).
BACKGROUND BACKGROUND
UKR accounts for 8.7% of knee arthroplasty in the UK each year. It has better functional outcome than total knee replacement for isolated single compartment arthritis but can result in complex surgery when revision is required. This is feared to result in poorer patient reported outcomes when compared to primary TKR. We aim to compare the clinical results of revised UKR with primary TKR, taking into account the survival length of the UKR.
PATIENTS AND METHODS METHODS
Forty-five patients (27 female) were retrospectively identified from our arthroplasty database that had undergone revision from UKR to TKR (1999-2014) and had a minimum of two years of follow-up post-revision. These patients were then matched with regards to age at primary procedure, sex, BMI and total arthroplasty life (UKR + Revision TKR) up to point of follow-up.
RESULTS RESULTS
In the UKR revision group (mean arthroplasty life 8.6 years) the mean Oxford knee score (OKS) was 31.8. In the primary knee group (mean arthroplasty life 8.4 years) the mean OKS was 32.8. This difference was not statistically significant. Fifteen out of 45 patients undergoing revision surgery required stemmed components.
CONCLUSION CONCLUSIONS
UKR provides comparable clinical outcome even after revision surgery to TKR as primary TKRs and should be considered in all patients meeting the selection criteria. Revision is complex and revision components should be available.

Identifiants

pubmed: 30792107
pii: S0968-0160(18)30962-1
doi: 10.1016/j.knee.2018.12.007
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

400-404

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Sam C Jonas (SC)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland. Electronic address: Sam.jonas@doctors.org.uk.

Paul Jermin (P)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.

Nick Howells (N)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.

Andrew Porteous (A)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.

James Murray (J)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.

James Robinson (J)

Avon Orthopaedic Centre, United Kingdom of Great Britain and Northern Ireland.

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