Clinical outcomes of various types of revision surgeries after unicompartmental knee arthroplasty failure

Shih Hui Peng, Chun Chieh Chen, Sheng Hsun Lee, Yu Chih Lin, Jui Fan Chiang, Szu Yuan Chen, Chih Chien Hu, Yuhan Chang, Pang Hsin Hsieh, Hsin Nung Shih, Chih Hsiang Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Purpose: The advantages of unicompartmental knee arthroplasty (UKA) have led to the procedure being increasingly performed worldwide. However, revision surgery is required after UKA failure. According to the literature review, the choice of implant in revision surgery remains a debatable concern. This study analyzed the clinical results of different types of prostheses used in treating failed UKA. Materials and methods: This is a retrospective review of 33 failed medial UKAs between 2006 and 2017. Demographic data, failure reason, types of revision prostheses, and the severity of bone defects were analyzed. The patients were classified into three groups: primary prosthesis, primary prosthesis with a tibial stem, and revision prosthesis. The implant survival rate and medical cost of the procedures were compared. Results: A total of 17 primary prostheses, 7 primary prostheses with tibial stems, and 9 revision prostheses were used. After a mean follow-up of 30.8 months, the survival outcomes of the three groups were 88.2%, 100%, and 88.9%, respectively (P = 0.640). The common bone defect in tibia site is Anderson Orthopedic Research Institute [AORI] grade 1 and 2a (16 versus 17). In patients with tibial bone defects AORI grade 2a, the failure rates of primary prostheses and primary prostheses with tibial stems were 25% and 0%, respectively. Conclusions: The most common cause for UKA failure was aseptic loosening. The adoption of a standardized surgical technique makes it easier to perform revision surgeries. Primary prostheses with tibial stems provided higher stability, leading to a lower failure rate due to less risk of aseptic loosening in patients with tibial AORI grade 2a. In our experience, we advise surgeons may try using primary prostheses in patients with tibial AORI grade 1 and primary prostheses with tibial stems in patients with tibial AORI grade 2a.

Original languageEnglish
Article number302
Pages (from-to)302
JournalBMC Musculoskeletal Disorders
Volume24
Issue number1
DOIs
StatePublished - 18 04 2023

Bibliographical note

© 2023. The Author(s).

Keywords

  • Aseptic loosening
  • Failed unicompartmental knee arthroplasty
  • Revision surgery
  • Arthroplasty, Replacement, Knee/adverse effects
  • Prosthesis Failure
  • Knee Joint/diagnostic imaging
  • Humans
  • Treatment Outcome
  • Knee Prosthesis/adverse effects
  • Retrospective Studies
  • Reoperation/adverse effects

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