Long-term results of per-operative knee arthroscopy in confirming suitability for unicompartmental arthroplasty.


Journal

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

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 23 08 2022
revised: 11 04 2023
accepted: 24 07 2023
medline: 30 10 2023
pubmed: 24 8 2023
entrez: 23 8 2023
Statut: ppublish

Résumé

Patient selection is key to the success of medial unicondylar knee arthroplasty (UKA). Progression of arthritis is the most common indication for revision surgery. Per-operative arthroscopy is a means of directly assessing the integrity of the lateral compartment. The aim of the study is to assess the long-term survivorship of UKA performed when per-operative arthroscopy is used as a final means of deciding whether to proceed with UKA. We used per-operative arthroscopy as a means to confirm suitability for UKA in a consecutive series of 279 Oxford medial UKA. Our series of UKA with per-operative arthroscopy (Group 1) was compared to all Oxford UKA (Group 2) and all UKA in the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) (Group 3). The 14-year cumulative percentage revision (CPR) was 18.5% (95% CI 12.7, 26.4) for group 1, 19.7% (95% CI 18.8, 20.6) for group 2, and 19.2% (95% CI 18.5, 19.8) for group 3. There was no statistically significant difference in the (CPR) for the entire period when group 1 was compared to groups 2 or 3. Progression of arthritis was least in Group 1 compared to groups 2 and 3; 3.6 versus 4.4 and 4.1% respectively. Following per-operative arthroscopy 21.6% (77/356) of knees underwent a change of surgical plan from UKA to TKA. In our practice, which includes per-operative arthroscopy, we have identified a reduced risk of revision due to progression of arthritis but no difference in overall long-term implant survivorship.

Sections du résumé

BACKGROUND BACKGROUND
Patient selection is key to the success of medial unicondylar knee arthroplasty (UKA). Progression of arthritis is the most common indication for revision surgery. Per-operative arthroscopy is a means of directly assessing the integrity of the lateral compartment. The aim of the study is to assess the long-term survivorship of UKA performed when per-operative arthroscopy is used as a final means of deciding whether to proceed with UKA.
METHODS METHODS
We used per-operative arthroscopy as a means to confirm suitability for UKA in a consecutive series of 279 Oxford medial UKA. Our series of UKA with per-operative arthroscopy (Group 1) was compared to all Oxford UKA (Group 2) and all UKA in the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) (Group 3).
RESULTS RESULTS
The 14-year cumulative percentage revision (CPR) was 18.5% (95% CI 12.7, 26.4) for group 1, 19.7% (95% CI 18.8, 20.6) for group 2, and 19.2% (95% CI 18.5, 19.8) for group 3. There was no statistically significant difference in the (CPR) for the entire period when group 1 was compared to groups 2 or 3. Progression of arthritis was least in Group 1 compared to groups 2 and 3; 3.6 versus 4.4 and 4.1% respectively. Following per-operative arthroscopy 21.6% (77/356) of knees underwent a change of surgical plan from UKA to TKA.
CONCLUSION CONCLUSIONS
In our practice, which includes per-operative arthroscopy, we have identified a reduced risk of revision due to progression of arthritis but no difference in overall long-term implant survivorship.

Identifiants

pubmed: 37611491
pii: S0968-0160(23)00160-6
doi: 10.1016/j.knee.2023.07.012
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

142-149

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

James R Gill (JR)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia. Electronic address: james.gill@wsh.nhs.uk.

Daniel J Brimm (DJ)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

Philip Dobson (P)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

Michael Goldberg (M)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

Peter J McMeniman (PJ)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

Timothy J McMeniman (TJ)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

Peter T Myers (PT)

Brisbane Orthopaedics and Sports Medicine Centre, Level 6, Specialist Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia.

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Classifications MeSH