Research progress in unicompartmental knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Dong ¹ , YANG Minzhi ^1,2 , CAO Zheng ^1,2 , KONG Xiangpeng ¹ , WANG Yi ¹ , GUO Renwen ¹ ,  CHAI Wei ¹

1. Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China;
2. Medicine School of Nankai University, Tianjin, 300071, P.R.China;

Corresponding author：

CHAI Wei, Email: chaiwei301@163.com

Keywords：

Unicompartmental knee arthroplasty; osteoarthritis; research progress

DOI：

10.7507/1002-1892.201906085

Video：

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Objective To summarize the clinical application and research progress in unicompartmental knee arthroplasty (UKA).Methods The literature related to UKA in recent years was reviewed and the emerging indications, implant options, comparisons between other surgical techniques, and recent advances were summarized.Results Clinical studies show that UKA has many advantages, such as less trauma, faster recovery, and fewer postoperative complications. At present, the operative indication has been expanded. The body mass index more than 25 kg/m², less than 60 years old, patellofemoral arthritis, and anterior cruciate ligament dysfunction are no longer considered as contraindications. The prosthesis type in UKA should be selected according to the patient’s condition. In recent years, the robot-assisted UKA can effectively improve the effectiveness, improve patient satisfaction, and reduce postoperative complications.Conclusion With the development of surgical techniques, designs of prosthesis, and the robotic technology, UKA would be further applicated. As more long-term data on UKA become available, it will further guide clinicians in counseling patients on whether UKA should be performed.

Citation： WU Dong, YANG Minzhi, CAO Zheng, KONG Xiangpeng, WANG Yi, GUO Renwen, CHAI Wei. Research progress in unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(2): 145-150. doi: 10.7507/1002-1892.201906085 Copy

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2.	Kim KT. Unicompartmental knee arthroplasty. Knee Surg Relat Res, 2018, 30(1): 1-2.
3.	Hamilton TW, Pandit HG, Jenkins C, et al. Evidence-based indications for mobile-bearing unicompartmental knee arthroplasty in a consecutive cohort of thousand knees. J Arthroplasty, 2017, 32(6): 1779-1785.
4.	Sundaram K, Warren J, Anis H, et al. An increased body mass index was not associated with higher rates of 30-day postoperative complications after unicompartmental knee arthroplasty. Knee, 2019, 26(3): 720-728.
5.	Xia Z, Liow MHL, Goh GS, et al. Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1691-1697.
6.	Xu S, Lim WJ, Chen JY, et al. The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. Bone Joint J, 2019, 101-B(2): 213-220.
7.	Lum ZC, Crawford DA, Lombardi AV Jr, et al. Early comparative outcomes of unicompartmental and total knee arthroplasty in severely obese patients. Knee, 2018, 25(1): 161-166.
8.	Henkel C, Mikkelsen M, Pedersen AB, et al. Medial unicompartmental knee arthroplasty: increasingly uniform patient demographics despite differences in surgical volume and usage-a descriptive study of 8,501 cases from the Danish Knee Arthroplasty Registry. Acta Orthop, 2019, 90(4): 354-359.
9.	Murray DW, Parkinson RW. Usage of unicompartmental knee arthroplasty. Bone Joint J, 2018, 100-B(4): 432-435.
10.	Witjes S, Hoorntje A, Kuijer PP, et al. Goal setting and achievement in individualized rehabilitation of younger total and unicondylar knee arthroplasty patients: A cohort study. Arch Phys Med Rehabil, 2019, 100(8): 1434-1441.
11.	Witjes S, van Geenen RC, Koenraadt KL, et al. Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions? Qual Life Res, 2017, 26(2): 403-417.
12.	van der List JP, Chawla H, Zuiderbaan HA, et al. The role of preoperative patient characteristics on outcomes of unicompartmental knee arthroplasty: A meta-analysis critique. J Arthroplasty, 2016, 31(11): 2617-2627.
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20.	Thein R, Zuiderbaan HA, Khamaisy S, et al. Medial unicondylar knee arthroplasty improves patellofemoral congruence: a possible mechanistic explanation for poor association between patellofemoral degeneration and clinical outcome. J Arthroplasty, 2015, 30(11): 1917-1922.
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35.	Kerens B, Schotanus MGM, Boonen B, et al. Cementless versus cemented Oxford unicompartmental knee arthroplasty: early results of a non-designer user group. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 703-709.
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1. Marmor L. Marmor modular knee in unicompartmental disease. Minimum four-year follow-up. J Bone Joint Surg (Am), 1979, 61(3): 347-353.
2. Kim KT. Unicompartmental knee arthroplasty. Knee Surg Relat Res, 2018, 30(1): 1-2.
3. Hamilton TW, Pandit HG, Jenkins C, et al. Evidence-based indications for mobile-bearing unicompartmental knee arthroplasty in a consecutive cohort of thousand knees. J Arthroplasty, 2017, 32(6): 1779-1785.
4. Sundaram K, Warren J, Anis H, et al. An increased body mass index was not associated with higher rates of 30-day postoperative complications after unicompartmental knee arthroplasty. Knee, 2019, 26(3): 720-728.
5. Xia Z, Liow MHL, Goh GS, et al. Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes. Knee Surg Sports Traumatol Arthrosc, 2018, 26(6): 1691-1697.
6. Xu S, Lim WJ, Chen JY, et al. The influence of obesity on clinical outcomes of fixed-bearing unicompartmental knee arthroplasty: a ten-year follow-up study. Bone Joint J, 2019, 101-B(2): 213-220.
7. Lum ZC, Crawford DA, Lombardi AV Jr, et al. Early comparative outcomes of unicompartmental and total knee arthroplasty in severely obese patients. Knee, 2018, 25(1): 161-166.
8. Henkel C, Mikkelsen M, Pedersen AB, et al. Medial unicompartmental knee arthroplasty: increasingly uniform patient demographics despite differences in surgical volume and usage-a descriptive study of 8,501 cases from the Danish Knee Arthroplasty Registry. Acta Orthop, 2019, 90(4): 354-359.
9. Murray DW, Parkinson RW. Usage of unicompartmental knee arthroplasty. Bone Joint J, 2018, 100-B(4): 432-435.
10. Witjes S, Hoorntje A, Kuijer PP, et al. Goal setting and achievement in individualized rehabilitation of younger total and unicondylar knee arthroplasty patients: A cohort study. Arch Phys Med Rehabil, 2019, 100(8): 1434-1441.
11. Witjes S, van Geenen RC, Koenraadt KL, et al. Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions? Qual Life Res, 2017, 26(2): 403-417.
12. van der List JP, Chawla H, Zuiderbaan HA, et al. The role of preoperative patient characteristics on outcomes of unicompartmental knee arthroplasty: A meta-analysis critique. J Arthroplasty, 2016, 31(11): 2617-2627.
13. Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg (Am), 1989, 71(1): 145-150.
14. Stern SH, Becker MW, Insall JN. Unicondylar knee arthroplasty. An evaluation of selection criteria. Clin Orthop Relat Res, 1993, (286): 143-148.
15. 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.
16. Pandit H, Jenkins C, Gill HS, et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J Bone Joint Surg (Br), 2011, 93(5): 622-628.
17. 朱若夫, 王治栋, 陈广东, 等. 髌股关节退变对膝关节内侧单髁置换术疗效影响的研究. 中国矫形外科杂志, 2018, 26(24): 2215-2219.
18. Parmaksizoğlu AS, Kabukçuoğlu Y, Ozkaya U, et al. Short-term results of the Oxford phase 3 unicompartmental knee arthroplasty for medial arthritis. Acta Orthop Traumatol Turc, 2010, 44(2): 135-142.
19. Beard DJ, Pandit H, Gill HS, et al. The influence of the presence and severity of pre-existing patellofemoral degenerative changes on the outcome of the Oxford medial unicompartmental knee replacement. J Bone Joint Surg (Br), 2007, 89(12): 1597-1601.
20. Thein R, Zuiderbaan HA, Khamaisy S, et al. Medial unicondylar knee arthroplasty improves patellofemoral congruence: a possible mechanistic explanation for poor association between patellofemoral degeneration and clinical outcome. J Arthroplasty, 2015, 30(11): 1917-1922.
21. 王宇, 岳家吉, 杨春喜. 髌股关节炎对人工单髁关节置换术疗效影响的研究进展. 中国修复重建外科杂志, 2019, 33(3): 377-381.
22. Goodfellow JW, Kershaw CJ, Benson MK, et al. The Oxford Knee for unicompartmental osteoarthritis. The first 103 cases. J Bone Joint Surg (Br), 1988, 70(5): 692-701.
23. Suter L, Roth A, Angst M, et al. Is ACL deficiency always a contraindication for medial UKA? Kinematic and kinetic analysis of implanted and contralateral knees Gait Posture, 2019, 68: 244-251.
24. Plancher KD, Dunn AS, Petterson SC. The anterior cruciate ligament-deficient knee and unicompartmental arthritis. Clin Sports Med, 2014, 33(1): 43-55.
25. Tian S, Wang B, Wang Y, et al. Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction in knees with osteoarthritis and deficient anterior cruciate ligament. BMC Musculoskelet Disord, 2016, 17: 327.
26. Mancuso F, Dodd CA, Murray DW, et al. Medial unicompartmental knee arthroplasty in the ACL-deficient knee. J Orthop Traumatol, 2016, 17(3): 267-275.
27. Ventura A, Legnani C, Terzaghi C, et al. Medial unicondylar knee arthroplasty combined to anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 675-680.
28. Iriberri I, Suau S, Payan L, et al. Long-term deterioration after one-stage unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction. Musculoskelet Surg, 2019, 103(3): 251-256.
29. Insall J, Walker P. Unicondylar knee replacement. Clin Orthop Relat Res, 1976, (120): 83-85.
30. Burger JA, Kleeblad LJ, Sierevelt IN, et al. Bearing design influences short- to mid-term survivorship, but not functional outcomes following lateral unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2019, 27(7): 2276-2288.
31. Goodfellow JW, O’Connor J. Clinical results of the Oxford knee. Surface arthroplasty of the tibiofemoral joint with a meniscal bearing prosthesis. Clin Orthop Relat Res, 1986, (205): 21-42.
32. Confalonieri N, Manzotti A, Pullen C. Comparison of a mobile with a fixed tibial bearing unicompartimental knee prosthesis: a prospective randomized trial using a dedicated outcome score. Knee, 2004, 11(5): 357-362.
33. Emerson RH Jr, Hansborough T, Reitman RD, et al. Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res, 2002, (404): 62-70.
34. Whittaker JP, Naudie DD, McAuley JP, et al. Does bearing design influence midterm survivorship of unicompartmental arthroplasty? Clin Orthop Relat Res, 2010, 468(1): 73-81.
35. Kerens B, Schotanus MGM, Boonen B, et al. Cementless versus cemented Oxford unicompartmental knee arthroplasty: early results of a non-designer user group. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 703-709.
36. Kendrick BJ, Kaptein BL, Valstar ER, et al. Cemented versus cementless Oxford unicompartmental knee arthroplasty using radiostereometric analysis: a randomised controlled trial. Bone Joint J, 2015, 97-B(2): 185-191.
37. Horsager K, Madsen F, Odgaard A, et al. Similar polyethylene wear between cemented and cementless Oxford medial UKA: a 5-year follow-up randomized controlled trial on 79 patients using radiostereometry. Acta Orthop, 2019, 90(1): 67-73.
38. New Zealand Orthopaedic Association. National Joint Registry Seven Year Report January1999 to December 2005 [R/OL]. [2019-11-23]. https://nzoa.org.nz/system/files/NJR%207%20Year%20Report.pdf.
39. New Zealand Orthopaedic Association. New Zealand Joint Registry Ninteen Year Report January1999 to December 2017[R/OL]. [2019-11-23]. https://nzoa.org.nz/system/files/DH8152_NZJR_2018_Report_v6_4Decv18.pdf.
40. Knifsund J, Reito A, Haapakoski J, et al. Short-term survival of cementless Oxford unicondylar knee arthroplasty based on the Finnish Arthroplasty Register. Knee, 2019, 26(3): 768-773.
41. Hooper N, Snell D, Hooper G, et al. The five-year radiological results of the uncemented Oxford medial compartment knee arthroplasty. Bone Joint J, 2015, 97-B(10): 1358-1363.
42. Stempin R, Stempin K, Kaczmarek W. Medium-term outcome of cementless, mobile-bearing, unicompartmental knee arthroplasty. Ann Transl Med, 2019, 7(3): 41.
43. Harbourne AD, Sanchez-Santos MT, Arden NK, et al. Predictors of return to desired activity 12 months following unicompartmental and total knee arthroplasty. Acta Orthop, 2019, 90(1): 74-80.
44. Filbay SR, Judge A, Delmestri A, et al. Evaluating patients’ expectations from a novel patient-Centered perspective predicts knee arthroplasty outcome. J Arthroplasty, 2018, 33(7): 2146-2152.
45. Goh GS, Bin Abd Razak HR, Tay DK, et al. Unicompartmental knee arthroplasty achieves greater flexion with no difference in functional outcome, quality of life, and satisfaction vs total knee arthroplasty in patients younger than 55 years. A propensity score-matched cohort analysis. J Arthroplasty, 2018, 33(2): 355-361.
46. Siman H, Kamath AF, Carrillo N, et al. Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplasty, 2017, 32(6): 1792-1297.
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