Projects per year
Abstract
INTRODUCTION: Biomechanical studies have suggested that proximal tibial strain is elevated in UKAs incorporating all-polyethylene tibial components with concern that this leads to premature failure. This study reports minimum 10-year outcomes for a UKA incorporating an all-polyethylene tibial component to determine whether these concerns were realised.
MATERIALS AND METHODS: 109 fixed bearing UKAs (97 patients, mean age 68 (range 48-87), 54/97 (56%) female) with all-polyethylene tibial components were followed up for ≥ 10 years with Oxford Knee Scores, Forgotten Joint Scores and Kaplan-Meier analysis. 106/109 implants were 7 mm, 3 were 9.5 mm.
RESULTS: Ten-year survival was 85.5% (78.6-92.4 95% CI) with the end-point failure for any reason. Unexplained pain was the commonest mode of failure (6/17) followed by lateral compartment osteoarthritis (5/17) and tibial subsidence/loosening (4/17). Revision rate was highest at 2-5 years due to revisions for unexplained pain. Ten-year survival was worse in patients < 65 years old (p = 0.035), in those with BMI > 30 (p = 0.017) and in those with postoperative increases in medial tibial sclerosis (p < 0.001 log-rank). Implant malalignment was not significantly associated with failure. Radioisotope bone scans in 16 patients all remained "hot" at mean 6.1 years (range 2.1-11.5). Relative risk of failure in patients < 65 years was 2.9 (1.2-7.0 95% CI) and when BMI > 30 was 2.9 (1.2-6.9 95% CI). In those with intact UKAs at 10 years, mean Oxford Knee Score was 34.8 ± 10.7, Forgotten Joint Score was 37.9 ± 26.7 and 96% were satisfied with their knee.
CONCLUSION: The high rate of early failure between 2 and 5 years in this all-polyethylene tibial component UKA did not persist in the long term. Though medial proximal tibial metabolic changes appear to persist they are not necessarily symptomatic. BMI > 30 and age < 65 years were significant risk factors for revision.
Original language | English |
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Journal | Archives of Orthopaedic and Trauma Surgery |
Early online date | 23 Feb 2018 |
DOIs | |
Publication status | E-pub ahead of print - 23 Feb 2018 |
Keywords / Materials (for Non-textual outputs)
- Journal Article
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Dive into the research topics of 'Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component'. Together they form a unique fingerprint.Projects
- 2 Finished
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reSTARt - Edinburgh Royal Infirmary Arthroplasty Outcomes Database
Non-EU industry, commerce and public corporations
1/01/15 → 31/03/20
Project: Research
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EORD: Edinburgh Orthopaedic Research Database Ethics Reference 16/SS/0026
MacDonald, D., Howie, C. & Simpson, H.
1/08/02 → 31/12/24
Project: Research