Joost A Burger1, Laura J Kleeblad2, Inger N Sierevelt3, Wieger G Horstmann3, Rutger C I van Geenen4, Liza N van Steenbergen5, Peter A Nolte3. 1. Department of Orthopaedic Surgery, Computer Assisted Surgery Center, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY. 2. Department of Orthopaedic Surgery, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands. 3. Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands. 4. Department of Orthopaedic Surgery, Amphia Hospital, Nijmegen, The Netherlands. 5. Dutch Arthroplasty Register, 's-Hertogenbosch, The Netherlands.
Abstract
BACKGROUND: The rarity of lateral unicompartmental knee arthroplasty (UKA) results in a lack of large cohort studies and understanding. The aim of this study is to comprehensively evaluate survivorship of lateral UKA with registry data and compare this to medial UKA. METHODS: Lateral (n = 537) and medial UKAs (n = 19,295) in 2007-2017 were selected from the Dutch Arthroplasty Register. Survival analyses were performed with revision for any reason as primary endpoint. Adjustments were made for patient and implant characteristics. Stratified analyses according to patient and implant characteristics were performed. Reasons and type of revision were grouped according to laterality and bearing design. RESULTS: The 5-year revision rate was 12.9% for lateral UKA and 9.3% for medial UKA. Multivariable regression analyses showed no significant increased risk for revision for lateral UKA (hazard ratio 0.87, 95% confidence interval 0.66-1.15). Stratified analyses showed that the effect of patient characteristics on revision was comparable between lateral and medial UKA; however, the use of mobile-bearing design for lateral UKA was associated with increased revision rate. Progression of osteoarthritis was the main reason for revision on both sides accompanied by tibia component loosening for medial UKA. Reasons and type of revision varied depending on bearing design. CONCLUSION: Similar survivorship of lateral and medial UKA was reported. Specifically, there is a notable risk for revision when using mobile-bearing designs for lateral UKA. Failure modes and type of revision depends on laterality and bearing design. These findings emphasize that surgical challenges related to anatomy and kinematics of the lateral and medial knee compartment need to be considered.
BACKGROUND: The rarity of lateral unicompartmental knee arthroplasty (UKA) results in a lack of large cohort studies and understanding. The aim of this study is to comprehensively evaluate survivorship of lateral UKA with registry data and compare this to medial UKA. METHODS: Lateral (n = 537) and medial UKAs (n = 19,295) in 2007-2017 were selected from the Dutch Arthroplasty Register. Survival analyses were performed with revision for any reason as primary endpoint. Adjustments were made for patient and implant characteristics. Stratified analyses according to patient and implant characteristics were performed. Reasons and type of revision were grouped according to laterality and bearing design. RESULTS: The 5-year revision rate was 12.9% for lateral UKA and 9.3% for medial UKA. Multivariable regression analyses showed no significant increased risk for revision for lateral UKA (hazard ratio 0.87, 95% confidence interval 0.66-1.15). Stratified analyses showed that the effect of patient characteristics on revision was comparable between lateral and medial UKA; however, the use of mobile-bearing design for lateral UKA was associated with increased revision rate. Progression of osteoarthritis was the main reason for revision on both sides accompanied by tibia component loosening for medial UKA. Reasons and type of revision varied depending on bearing design. CONCLUSION: Similar survivorship of lateral and medial UKA was reported. Specifically, there is a notable risk for revision when using mobile-bearing designs for lateral UKA. Failure modes and type of revision depends on laterality and bearing design. These findings emphasize that surgical challenges related to anatomy and kinematics of the lateral and medial knee compartment need to be considered.
Authors: Saeed Asadollahi; Hannah A Wilson; Fraser R Thomson; Kenneth Vaz; Rob Middleton; Cathy Jenkins; Abtin Alvand; Nicholas Bottomley; Chris A Dodd; Andrew J Price; David W Murray; William F Jackson Journal: J Orthop Surg Res Date: 2022-03-05 Impact factor: 2.359