Medium- and long-term assessment of lateral compartment and patellofemoral compartment osteoarthritis after medial unicompartmental knee arthroplasty with Oxford mobile-bearing

doi:10.12307/2021.320

Abstract

Abstract: BACKGROUND: Unicompartmental knee arthroplasty has attracted more and more attention because of its advantages, such as less trauma, faster recovery, less cost and better proprioception. However, there are few studies on the medium- and long-term development of lateral compartment and patellofemoral compartment osteoarthritis after mobile-bearing medial unicompartmental knee arthroplasty.
OBJECTIVE: To evaluate the progression of posterolateral and patellofemoral osteoarthritis with mobile-bearing medial unicompartmental knee arthroplasty.
METHODS: Totally 95 patients who underwent mobile-bearing medial unicompartmental knee arthroplasty in the Department of Orthopedics of First Affiliated Hospital of Zhengzhou University from January 2011 to January 2016 were retrospectively analyzed. Lateral compartment osteoarthritis was assessed by Kellgren-Lawrence classification based on preoperative and final follow-up knee radiographs; there were advanced group (n=32) and non-advanced group (n=63). Patellofemoral compartment osteoarthritis was assessed by Kellgren-Lawrence classification; there were advanced group (n=41) and non-advanced group (n=54). Imaging and clinical features were compared in the advanced group and non-advanced group to analyze the relationship between the postoperative effect and the progression of lateral and patellofemoral compartment osteoarthritis.
RESULTS AND CONCLUSION: (1) During final follow-up, compared with the non-advanced group, Hospital for Special Surgery scores were lower in the advanced group after lateral compartment osteoarthritis (P < 0.05); however, the visual analogue scale score and forgotten joint score were higher (P < 0.05). (2) The incidence of osteoarthritis progression in the lateral compartment (33.7%) was less than that in the patellofemoral compartment (43.2%) after mobile-bearing medial Unicompartmental knee arthroplasty. There was no significant correlation between the progression of lateral compartment osteoarthritis and the progression of patellofemoral compartment osteoarthritis (P > 0.05). (3) After 5-10 years follow-up, there were no complications such as infection, polyethylene gasket dislocation or periprosthetic fracture. (4) The medium and long-term outcomes of the mobile-bearing medial unicompartmental knee arthroplasty were mainly affected by the progression of lateral compartment osteoarthritis, but not by the patellofemoral compartment.

Key words: Key words, unicompartmental knee arthroplasty, mobile bearing, lateral compartment, patellofemoral compartment, osteoarthritis, forgotten joint score, visual analogue scale, Hospital for Special Surgery score

CLC Number:

Qiao Renqiu, Yin Li, Zhang Yi, Wang Haitao, Xia Peige, Kong Zhiheng. Medium- and long-term assessment of lateral compartment and patellofemoral compartment osteoarthritis after medial unicompartmental knee arthroplasty with Oxford mobile-bearing[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(33): 5318-5323.

Figures/Tables 6

References

[1] SATKU K. Unicompartmental knee arthroplasty: is it a step in the right direction? Surgical options for osteoarthritis of the knee. Singapore Med J. 2003;44(11):554-556.
[2] van MIDDELKOOP M, BENNELL KL, CALLAGHAN MJ, et al. International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. Semin Arthritis Rheum. 2018;47(5):666-675.
[3] WILSON HA, MIDDLETON R, ABRAM S, et al. Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. BMJ. 2019;364:1352.
[4] LUM ZC, LOMBARDI AV, HURST JM, et al. Early outcomes of twin-peg mobile-bearing unicompartmental knee arthroplasty compared with primary total knee arthroplasty. Bone Joint J. 2016;98-B(10 Supple B): 28-33.
[5] LIDDLE AD, PANDIT H, JUDGE A, et al. Optimal usage of unicompartmental knee arthroplasty: a study of 41,986 cases from the National Joint Registry for England and Wales. Bone Joint J. 2015; 97-B(11):1506-1511.
[6] MILLER S, AGARWAL A, HADDON WB, et al. Comparison of gait kinetics in total and unicondylar knee replacement surgery. Ann R Coll Surg Engl. 2018;100(4):267-274.
[7] MURRAY DW, GOODFELLOW JW, O’CONNOR JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br. 1998;80(6):983-989.
[8] HAMILTON TW, PANDIT HG, MAURER DG, et al. Anterior knee pain and evidence of osteoarthritis of the patellofemoral joint should not be considered contraindications to mobile-bearing unicompartmental knee arthroplasty: a 15-year follow-up. Bone Joint J. 2017;99-B(5):632-639.
[9] FORNELL S, PRADA E, BARRENA P, et al. Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty. Knee. 2018;25(6): 1206-1213.
[10] KLEEBLAD LJ, BORUS TA, COON TM, et al. Midterm survivorship and patient satisfaction of robotic-arm-assisted medial unicompartmental knee arthroplasty: a multicenter study. J Arthroplasty. 2018;33(6): 1719-1726.
[11] SIERRA RJ, KASSEL CA, WETTERS NG, et al. Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk. J Arthroplasty. 2013;28(8 Suppl):128-132.
[12] CHENG T, CHEN D, ZHU C, et al. Fixed-versus mobile-bearing unicondylar knee arthroplasty: are failure modes different? Knee Surg Sports Traumatol Arthrosc. 2013;21(11):2433-2441.
[13] KUMAR H, PAL CP, SHARMA YK, et al. Epidemiology of knee osteoarthritis using Kellgren and Lawrence scale in Indian population. J Clin Orthop Trauma. 2020;11(Suppl 1):S125-S129.
[14] RANAWAT CS, INSALL J, SHINE J. Duo-condylar knee arthroplasty: hospital for special surgery design. Clin Orthop Relat Res. 1976;(120): 76-82.
[15] HUSKISSON EC. Measurement of pain. Lancet. 1974;2(7889):1127-1131.
[16] CAO S, LIU N, HAN W, et al. Simplified Chinese version of the Forgotten Joint Score (FJS) for patients who underwent joint arthroplasty: cross-cultural adaptation and validation. J Orthop Surg Res. 2017;12(1):6.
[17] 王波,余楠生.膝骨关节炎阶梯治疗专家共识(2018年版)[J].中华关节外科杂志(电子版),2019,13(1):124-130.
[18] PETERFY CG, GUERMAZI A, ZAIM S, et al. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage. 2004;12(3):177-190.
[19] WANG K, XING D, DONG S, et al. The global state of research in nonsurgical treatment of knee osteoarthritis: a bibliometric and visualized study. BMC Musculoskelet Disord, 2019;20(1):407.
[20] FORNELL S, PRADA E, BARRENA P, et al. Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty. Knee. 2018;25(6):1206-1213.
[21] 吴东,杨敏之,曹正,等.膝关节单髁置换术研究进展[J].中国修复重建外科杂志,2020,34(2):145-150.
[22] SCHROER WC, BARNES CL, DIESFELD P, et al. The Oxford unicompartmental knee fails at a high rate in a high-volume knee practice. Clin Orthop Relat Res. 2013;471(11):3533-3539.
[23] 刘晓东,凃意辉.膝关节单髁置换术的临床应用进展[J].中华关节外科杂志(电子版),2010,4(6):804-808.
[24] 孙康,田少奇,张积华,等.膝关节单室置换的近期疗效[J].中华骨科杂志,2009,29(7):648-652.
[25] KULSHRESTHA V, DATTA B, KUMAR S, et al. Outcome of unicondylar knee arthroplasty vs total knee arthroplasty for early medial compartment arthritis: a randomized study. J Arthroplasty. 2017;32(5): 1460-1469.
[26] SUN PF, JIA YH. Mobile bearing UKA compared to fixed bearing TKA: a randomized prospective study. Knee. 2012;19(2):103-106.
[27] BERGER RA, MENEGHINI RM, JACOBS JJ, et al. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87(5):999-1006.
[28] SUN JN, CHEN W, ZHANG Y, et al. Does cognitive behavioral education reduce pain and improve joint function in patients after total knee arthroplasty? A randomized controlled trial. Int Orthop. 2020;44(10):2027-2035.
[29] LYONS MC, MACDONALD SJ, SOMERVILLE LE, et al. Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res. 2012;470(1):84-90.
[30] LIM JW, COUSINS GR, CLIFT BA, et al. Oxford unicompartmental knee arthroplasty versus age and gender matched total knee arthroplasty-functional outcome and survivorship analysis. J Arthroplasty. 2014; 29(9):1779-1783.
[31] VAN DER LIST JP, ZUIDERBAAN HA, PEARLE AD. Why Do Medial Unicompartmental Knee Arthroplasties Fail Today? J Arthroplasty. 2016;31(5):1016-1021.
[32] LIM JW, COUSINS GR, CLIFT BA, et al. Oxford unicompartmental knee arthroplasty versus age and gender matched total knee arthroplasty-functional outcome and survivorship analysis. J Arthroplasty. 2014;29(9):1779-1783.
[33] KIM SJ, POSTIGO R, KOO S, et al. Causes of revision following Oxford phase 3 unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1895-1901.
[34] PANDIT H, HAMILTON T W, JENKINS C, et al. The clinical outcome of minimally invasive Phase 3 Oxford unicompartmental knee arthroplasty: a 15-year follow-up of 1000 UKAs. Bone Joint J. 2015; 97-B(11):1493-1500.
[35] LORBACH O, PAPE D, MOSSER P, et al. Medial unicondylar knee replacement. Orthopade. 2014;43(10):875-876,878-882.
[36] MOFIDI A, LU B, PLATE JF, et al. Effect of arthritis in other compartment after unicompartmental arthroplasty. Eur J Orthop Surg Traumatol. 2014;24(5):805-812.
[37] BEREND KR, LOMBARDI AJ, MORRIS MJ, et al. Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival? Orthopedics. 2011;34(9):e494-e496.
[38] SONG EK, PARK JK, PARK CH, et al. No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2016;24(1):208-213.
[39] KALAAI S, SCHOLTES M, BORGHANS R, et al. Comparable level of joint awareness between the bi-cruciate and cruciate retaining total knee arthroplasty with patient-specific instruments: a case-controlled study. Knee Surg Sports Traumatol Arthrosc. 2020;28(6):1835-1841.
[40] THIENPONT E, ZORMAN D. Higher forgotten joint score for fixed-bearing than for mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016;24(8):2641-2645.
[41] BEHREND H, GIESINGER K, GIESINGER JM, et al. The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty. 2012;27(3):430-436.
[42] PEERSMAN G, VERHAEGEN J, FAVIER B. The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study. Int Orthop. 2019;43(12):2739-2745.
[43] ZUIDERBAAN HA, van der LIST JP, KHAMAISY S, et al. Unicompartmental knee arthroplasty versus total knee arthroplasty: which type of artificial joint do patients forget? Knee Surg Sports Traumatol Arthrosc. 2017;25(3):681-686.

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