Medial unicondylar knee arthroplasty should be reserved for patients with complete joint space collapse
Autor: | Dietmar Dammerer, Hermann Leitner, Martin Krismer, Anna Zechling, B. Pfeifer, Alexander Wurm, Michael Liebensteiner |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
WOMAC Knee Joint Sports medicine Radiography medicine.medical_treatment Osteoarthritis 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Unicondylar Knee Arthroplasty Arthroplasty Replacement Knee Aged Retrospective Studies 030203 arthritis & rheumatology Pain Postoperative 030222 orthopedics business.industry Middle Aged Osteoarthritis Knee medicine.disease Arthroplasty Surgery Treatment Outcome Orthopedic surgery Implant business |
Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 30:3162-3167 |
ISSN: | 1433-7347 0942-2056 |
DOI: | 10.1007/s00167-021-06588-7 |
Popis: | Purpose To determine whether preoperative radiologic joint space width (JSW) is related to the outcome of medial unicondylar knee arthroplasty (UKA) (primary hypothesis). Methods A retrospective comparative analysis was performed. One group was comprised of UKA patients with preoperative JSW 0–1 mm. Another group was made up of patients with preoperative JSW ≥ 2 mm (range 0–4 mm). The JSW was measured from preoperative weight-bearing Schuss-view radiographs. The clinical outcome was determined with the Western Ontario and MacMaster Universities (WOMAC) Osteoarthritis Index score preoperatively and 1 year after medial UKA. Implant survival data were obtained from the arthroplasty register of Tyrol. Results There were 80 patients with a preoperative JSW 0–1 mm (age 66, BMI 27.8) and 70 patients with a preoperative JSW ≥ 2 mm (age 64, IQR 15, BMI 28.1). WOMAC total was 10 ± 10 in patients with 0–1 mm JSW and 25 ± 47 in patients with ≥ 2 mm JSW at 1 year postoperative (p = 0.052). WOMAC pain at 1 year postoperative was 7 ± 16 in patients with 0–1 mm JSW and 18 ± 46 in patients with ≥ 2 mm JSW (p = 0.047). WOMAC function at 1 year postoperative was 10 ± 9 in patients with 0–1 mm JSW and 17 ± 51 in patients with ≥ 2 mm JSW (p = 0.048). In patients with 0–1 mm JSW 5 year prosthesis survival was 92.3% and in patients with ≥ 2 mm JSW, it was 81.1% (p = 0.016). Conclusions In patients with preoperative complete joint space collapse (0–1 mm JSW), clinical outcome was superior to that of patients with incomplete joint space collapse. This was true for both 1 year postoperative WOMAC pain and WOMAC function and for 5 year implant survival rates. On the basis of our findings, it is recommended that ‘complete joint space collapse’ especially be used to achieve best clinical outcome in medial UKA surgery. Level of evidence IV. |
Databáze: | OpenAIRE |
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