Differentiated approach in the choice of arthroplasty in medial knee osteoarthritis (literature review)

February 18, 2022
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Resume

Aim: to analyze the advantages and disadvantages of using unicompartmental and total knee replacement in case of medial knee osteoarthritis, to determine the existing differential criteria for choosing the method of arthroplasty, taking into account the individual patient’s risk factors.

Results. Analysis of data from the modern literature did not allow to determine clear differential criteria for choosing the optimal method of arthroplasty in medial knee osteoarthritis, taking into account the individual patient’s risk factors. Unicompartmental knee replacement is associated with better functional outcomes, lower incidence of complications, faster recovery, and greater patient satisfaction. In addition, there are no convincing claims of a statistically significant difference in the frequency of revisions or longevity of implants, which have long been considered significant benefits of total knee replacement.

Conclusion. Due to the improvement of surgical techniques and greater availability in the choice of implants, unicompartmental knee replacement has proven to be an effective method of treatment of isolated medial knee osteoarthritis.

References

  • 1. Шуба В.Й. (2016) Остеоартроз: рання діагностика та лікування. Укр. мед. часопис, 1(111): http://www.umj.com.ua/article/93870.
  • 2. Wallace I.J., Worthington S., Felson D.T. et al. (2017) Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc. Natl. Acad. Sci. USA, 114: 9332–9336.
  • 3. Castiello E., Affatato S. (2020) Progression of osteoarthritis and reoperation in unicompartmental knee arthroplasty: A comparison of national joint registries. Int. J. Art. Org., 43(3): 203–207. doi.org/10.1177/0391398819879697.
  • 4. Costa G.G., Lo Presti M., Grassi A. et al. (2019) Metal-backed tibial components do not reduce risk of early aseptic loosening in unicompartmental knee arthroplasty: a systematic review and meta-analysis. J. Knee Surg. DOI: 10.1055/s-0038-1677506.
  • 5. Casper D.S., Fleischman A.N., Papas P.V. et al. (2019) Unicompartmental Knee Arthroplasty Provides Significantly Greater Improvement in Function than Total Knee Arthroplasty Despite Equivalent Satisfaction for Isolated Medial Compartment Osteoarthritis. J. Arthroplast., 34(8): 1611–1616. doi.org/10.1016/j.arth.2019.04.005.
  • 6. Longo U.G., Loppini M., Trovato U. et al. (2015) No difference between unicompartmental versus total knee arthroplasty for the management of medial osteoarthtritis of the knee in the same patient: a systematic review and pooling data analysis. Br. Med. Bull., 114(1): 65–73. doi.org/10.1093/bmb/ldv009.
  • 7. de Jesus C., Stacey D., Dervin G.F. (2017) Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis. J. Arthroplast., 32(11): 3340–3344. doi.org/10.1016/j.arth.2017.06.014.
  • 8. Deng M., Hu Y., Zhang Z. et al. (2021) Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis. Arch. Orthopaed. Trauma Surg., 141(8): 1361–1372. doi.org/10.1007/s00402-021-03790-7.
  • 9. Eberbach H., Mehl J., Feucht M.J. et al. (2017) Geometry of the valgus knee: contradicting the dogma of a femoral-based deformity. Am. J. Sports Med., 45: 909–914.
  • 10. Siman H., Kamath A.F., Carrillo N. et al. (2017) 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, 32(6): 1792–1797. doi: 10.1016/j.arth.2017.01.020
  • 11. Fabre-Aubrespy M., Ollivier M., Pesenti S. et al. (2016) Unicompartmental knee arthroplasty in patients older than 75 results in better clinical outcomes and similar survivorship compared to total knee arthroplasty: a matched controlled study. J. Arthroplasty, 31(12): 2668–2671.
  • 12. Tripathy S.K., Varghese P., Srinivasan A. et al. (2021) Joint awareness after unicompartmental knee arthroplasty and total knee arthroplasty: a systematic review and meta-analysis of cohort studies. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 29(10): 3478–3487. doi.org/10.1007/s00167-020-06327-4.
  • 13. Parisi T.J., Levy D.L., Dennis D.A. et al. (2018) Radiographic changes in nonoperative contralateral knee after unilateral total knee arthroplasty. J. Arthroplasty, 33: S116–S120.
  • 14. Pfitzner T., Perka C., von Roth P. (2017) AE-Beitrag: unikondylärer ersatz vs. totalendoprothese bei medialer gonarthrose. Z. Orthop. Unfall., 155: 527–533.
  • 15. Huang X., Li H., Chen B. et al. (2021) The incidence and risk factors of contralateral knee arthroplasty after primary unilateral unicompartmental knee arthroplasty. Medicine, 100(32): e26825. doi.org/10.1097/MD.0000000000026825
  • 16. Mohammad H.R., Strickland L., Hamilton T.W. et al. (2018) Long-term outcomes of over 8,000 medial Oxford phase 3 unicompartmental knees — a systematic review. Acta Orthop., 89: 101–107.
  • 17. https://www.nzoa.org.nz/nzoa-joint-registry
  • 18. https://ripo.cineca.it/
  • 19. https://ripo.cineca.it/pdf/report_eng_2016.pdf
  • 20. Arirachakaran A., Choowit P., Putananon C. et al. (2015) Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial. Eur. J. Orthop. Surg. Traumatol., 25(5): 799–806. DOI: 10.1007/s00590-015-1610-9
  • 21. Liddle A.D., Judge A., Pandit H., Murray D.W. (2014) Adverse outcomes after total and unicompartmental knee replacement in 101330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet, 384(9952): 1437–1445. doi.org/10.1016/S0140-6736(14)60419-0
  • 22. Blevins J.L., Carroll K.M., Burger J.A. et al. (2020) Postoperative outcomes of total knee arthroplasty compared to unicompartmental knee arthroplasty: a matched comparison. Knee 27(2): 565–571. DOI: 10.1016/j.knee.2019.12.005
  • 23. Kleeblad L.J., Borus T.A., Coon T.M. et al. (2018) Midterm survivorship and patient satisfaction of robotic-arm-assisted medial unicompartmental knee arthroplasty: a multicenter study. J. Arthroplasty, 33(6): 1719–1726. DOI: 10.1016/j.arth.2018.01.036
  • 24. Murray D.W., Parkinson R.W. (2018) Usage of unicompartmental knee arthroplasty. Bone Joint J.,100-B(4): 432–435.
  • 25. Clement N.D., Bell A., Simpson P. et al. (2020) Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis. Bone Joint Res., 9(1): 15–22. DOI: 10.1302/2046-3758.91.BJR-2019-0147.R1
  • 26. Kim M.S., Koh I.J., Choi Y.J. et al. (2017) Differences in patient-reported outcomes between unicompartmental and total knee arthroplasties: a propensity score-matched analysis. J. Arthroplasty, 32(5): 1453–1459. DOI: 10.1016/j.arth.2016.11.034
  • 27. Hiyama Y., Wada O., Nakakita S., Mizuno K. (2016) Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength. Orthop. Traumatol. Surg. Res., 102(4): 435–439. DOI: 10.1016/j.otsr.2016.02.007
  • 28. Vasso M., Del Regno C., D’Amelio A. et al. (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee, 22(2): 117–121. DOI: 10.1016/j.knee.2014.12.004
  • 29. Brown N.M., Sheth N.P., Davis K. et al. (2012) Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J. Arthroplast. 27(8 Suppl): 86–90. https://doi.org/10.1016/j.arth.2012.03.022
  • 30. Foran J.R.H., Brown N.M., Valle C.J.D. et al. (2013) Long-term Survivorship and Failure Modes of Unicompartmental Knee Arthroplasty. Clin. Orthop. Relat. Res., 471(1): 102–108. doi: 10.1007/s11999-012-2517-y
  • 31. Newman J.H., Ackroyd C.E., Shah N.A. (1998) Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. J. Bone Joint Surg. Br., 80(5): 862–865. doi: 10.1302/0301-620x.80b5.8835
  • 32. Thienpont E., Opsomer G., Koninckx A., Houssiau F. (2014) Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint score. J. Arthroplasty, 29(1): 48–51. doi: 10.1016/j.arth.2013.04.024