Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)
Unicompartmental Knee Arthroplasties are Performed on the Patients with Radiologically Too Mild Osteoarthritis
Julkaisun tekijät: Knifsund J, Hatakka J, Keemu H, Mäkelä K, Koivisto M, Niinimäki T
Kustantaja: SAGE PUBLICATIONS LTD
Julkaisuvuosi: 2017
Journal: Scandinavian Journal of Surgery
Tietokannassa oleva lehden nimi: SCANDINAVIAN JOURNAL OF SURGERY
Lehden akronyymi: SCAND J SURG
Volyymi: 106
Julkaisunumero: 4
Aloitussivu: 338
Lopetussivun numero: 341
Sivujen määrä: 4
ISSN: 1457-4969
eISSN: 1799-7267
DOI: http://dx.doi.org/10.1177/1457496917701668
Verkko-osoite: http://journals.sagepub.com/doi/10.1177/1457496917701668
Tiivistelmä
Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates.Aims: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty.Methods: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years.Results and Conclusion: The knees with a preoperative Kellgren-Lawrence grade of 0-2 osteoarthritis had a higher risk of reoperation than those with a Kellgren-Lawrence grade of 3-4 (odds ratio = 1.89; 95% confidence interval, 1.03-3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.
Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates.Aims: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty.Methods: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years.Results and Conclusion: The knees with a preoperative Kellgren-Lawrence grade of 0-2 osteoarthritis had a higher risk of reoperation than those with a Kellgren-Lawrence grade of 3-4 (odds ratio = 1.89; 95% confidence interval, 1.03-3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.
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