High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty.

Danilo Bruni, Stefano Zaffagnini, Francesco Iacono, Laura Bragonzoni, Mirco Lo Presti, Maria Pia Neri, Giulio Maria Marcheggiani Muccioli, Marco Nitri, Giovanni Francesco Raspugli, Maurilio Marcacci

Research output: Contribution to journalArticle

Abstract

PURPOSE: To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment. METHODS: Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months). In 44 patients, the diagnosis was osteoarthritis, and in 32 patients, it was avascular necrosis of the medial femoral condyle. The Hospital for Special Surgery Score was used for objective clinical evaluation, and a self-administered visual analogue scale was used to quantify residual pain at each observation point. Implant survivorship was determined assuming revision for any reason as endpoint. RESULTS: Nineteen patients were revised (6 with osteoarthritis and 13 with avascular necrosis of the medial femoral condyle). The mean interval time from index surgery to revision was 11.2 months (SD 4.66 months). Implant survivorship was higher in patients with osteoarthritis with respect to those with avascular necrosis of the medial femoral condyle (p = 0.018). Aseptic loosening was the most frequent failure mechanism. Femoral component loosening was reported in five patients and tibial component loosening was reported in other six patients. Assuming revision for any reason as endpoint, an implant survivorship of 74.3 % at 6-year follow-up was determined. In the remaining 57 patients, satisfactory clinical results were obtained. Hospital for Special Surgery Score and visual analogue scale for residual pain showed significant improvements (p < 0.03 and p < 0.045, respectively). CONCLUSIONS: At the present time, the standard cemented implants and the conventional designs for unicompartmental knee replacement still represent the optimal solution. The authors do not recommend the widespread use of this technique. LEVEL OF EVIDENCE: IV.
Original languageEnglish
Pages (from-to)3175-3182
Number of pages8
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume24
Issue number10
DOIs
Publication statusPublished - 2016

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Knee Replacement Arthroplasties
Thigh
Survival Rate
Osteoarthritis
Special Hospital
Necrosis
Bone and Bones
Pain Measurement
Visual Analog Scale
Reoperation
Arthroplasty
Observation
Pain

Keywords

  • Aseptic loosening
  • Cementless fixation
  • Focal resurfacing
  • Minimal bone resection
  • Minimally invasive surgery
  • Unicompartmental knee replacement

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High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty. / Bruni, Danilo; Zaffagnini, Stefano; Iacono, Francesco; Bragonzoni, Laura; Lo Presti, Mirco; Neri, Maria Pia; Muccioli, Giulio Maria Marcheggiani; Nitri, Marco; Raspugli, Giovanni Francesco; Marcacci, Maurilio.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 24, No. 10, 2016, p. 3175-3182.

Research output: Contribution to journalArticle

Bruni, Danilo ; Zaffagnini, Stefano ; Iacono, Francesco ; Bragonzoni, Laura ; Lo Presti, Mirco ; Neri, Maria Pia ; Muccioli, Giulio Maria Marcheggiani ; Nitri, Marco ; Raspugli, Giovanni Francesco ; Marcacci, Maurilio. / High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2016 ; Vol. 24, No. 10. pp. 3175-3182.
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abstract = "PURPOSE: To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment. METHODS: Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months). In 44 patients, the diagnosis was osteoarthritis, and in 32 patients, it was avascular necrosis of the medial femoral condyle. The Hospital for Special Surgery Score was used for objective clinical evaluation, and a self-administered visual analogue scale was used to quantify residual pain at each observation point. Implant survivorship was determined assuming revision for any reason as endpoint. RESULTS: Nineteen patients were revised (6 with osteoarthritis and 13 with avascular necrosis of the medial femoral condyle). The mean interval time from index surgery to revision was 11.2 months (SD 4.66 months). Implant survivorship was higher in patients with osteoarthritis with respect to those with avascular necrosis of the medial femoral condyle (p = 0.018). Aseptic loosening was the most frequent failure mechanism. Femoral component loosening was reported in five patients and tibial component loosening was reported in other six patients. Assuming revision for any reason as endpoint, an implant survivorship of 74.3 {\%} at 6-year follow-up was determined. In the remaining 57 patients, satisfactory clinical results were obtained. Hospital for Special Surgery Score and visual analogue scale for residual pain showed significant improvements (p < 0.03 and p < 0.045, respectively). CONCLUSIONS: At the present time, the standard cemented implants and the conventional designs for unicompartmental knee replacement still represent the optimal solution. The authors do not recommend the widespread use of this technique. LEVEL OF EVIDENCE: IV.",
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author = "Danilo Bruni and Stefano Zaffagnini and Francesco Iacono and Laura Bragonzoni and {Lo Presti}, Mirco and Neri, {Maria Pia} and Muccioli, {Giulio Maria Marcheggiani} and Marco Nitri and Raspugli, {Giovanni Francesco} and Maurilio Marcacci",
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T1 - High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty.

AU - Bruni, Danilo

AU - Zaffagnini, Stefano

AU - Iacono, Francesco

AU - Bragonzoni, Laura

AU - Lo Presti, Mirco

AU - Neri, Maria Pia

AU - Muccioli, Giulio Maria Marcheggiani

AU - Nitri, Marco

AU - Raspugli, Giovanni Francesco

AU - Marcacci, Maurilio

PY - 2016

Y1 - 2016

N2 - PURPOSE: To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment. METHODS: Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months). In 44 patients, the diagnosis was osteoarthritis, and in 32 patients, it was avascular necrosis of the medial femoral condyle. The Hospital for Special Surgery Score was used for objective clinical evaluation, and a self-administered visual analogue scale was used to quantify residual pain at each observation point. Implant survivorship was determined assuming revision for any reason as endpoint. RESULTS: Nineteen patients were revised (6 with osteoarthritis and 13 with avascular necrosis of the medial femoral condyle). The mean interval time from index surgery to revision was 11.2 months (SD 4.66 months). Implant survivorship was higher in patients with osteoarthritis with respect to those with avascular necrosis of the medial femoral condyle (p = 0.018). Aseptic loosening was the most frequent failure mechanism. Femoral component loosening was reported in five patients and tibial component loosening was reported in other six patients. Assuming revision for any reason as endpoint, an implant survivorship of 74.3 % at 6-year follow-up was determined. In the remaining 57 patients, satisfactory clinical results were obtained. Hospital for Special Surgery Score and visual analogue scale for residual pain showed significant improvements (p < 0.03 and p < 0.045, respectively). CONCLUSIONS: At the present time, the standard cemented implants and the conventional designs for unicompartmental knee replacement still represent the optimal solution. The authors do not recommend the widespread use of this technique. LEVEL OF EVIDENCE: IV.

AB - PURPOSE: To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment. METHODS: Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months). In 44 patients, the diagnosis was osteoarthritis, and in 32 patients, it was avascular necrosis of the medial femoral condyle. The Hospital for Special Surgery Score was used for objective clinical evaluation, and a self-administered visual analogue scale was used to quantify residual pain at each observation point. Implant survivorship was determined assuming revision for any reason as endpoint. RESULTS: Nineteen patients were revised (6 with osteoarthritis and 13 with avascular necrosis of the medial femoral condyle). The mean interval time from index surgery to revision was 11.2 months (SD 4.66 months). Implant survivorship was higher in patients with osteoarthritis with respect to those with avascular necrosis of the medial femoral condyle (p = 0.018). Aseptic loosening was the most frequent failure mechanism. Femoral component loosening was reported in five patients and tibial component loosening was reported in other six patients. Assuming revision for any reason as endpoint, an implant survivorship of 74.3 % at 6-year follow-up was determined. In the remaining 57 patients, satisfactory clinical results were obtained. Hospital for Special Surgery Score and visual analogue scale for residual pain showed significant improvements (p < 0.03 and p < 0.045, respectively). CONCLUSIONS: At the present time, the standard cemented implants and the conventional designs for unicompartmental knee replacement still represent the optimal solution. The authors do not recommend the widespread use of this technique. LEVEL OF EVIDENCE: IV.

KW - Aseptic loosening

KW - Cementless fixation

KW - Focal resurfacing

KW - Minimal bone resection

KW - Minimally invasive surgery

KW - Unicompartmental knee replacement

U2 - 10.1007/s00167-014-3444-0

DO - 10.1007/s00167-014-3444-0

M3 - Article

VL - 24

SP - 3175

EP - 3182

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 10

ER -