Burak AKAN, Tuğrul YILDIRIM, BERK GÜÇLÜ, ALPER KAYA, Doğaç KARAGÜVEN, İlker ÇETİN

Outcomes for revision total knee replacement after unicompartmental knee replacement

Objective: The aim of this retrospective, observational study was to describe the outcomes of total knee replacement (TKR) after failed Oxford phase 3 medial unicompartmental knee replacement (UKR). Methods: The study included 24 revision TKRs (20 females, 4 males; mean age: 61 years) performed following failed aseptic UKR. Outcomes were assessed using the Knee Society Score (KSS). Results: The most common causes for revision were mobile bearing dislocation and unexplained pain. Mean preoperative KSS was 50.3 (range: 37 to 66) and 82.2 (range: 58 to 97) after TKR. There were 17 excellent, 4 good, 2 fair and 1 poor results. Conclusion: The type of UKR performed (cemented versus uncemented) had no effect on TKR success. Revision for failed UKR with TKR appears to be a technically straightforward procedure with satisfactory early clinical results.

___

Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998;80:983-9.

Saenz CL, McGrath MS, Marker DR, Seyler TM, Mont MA, Bonutti PM. Early failure of a unicompartmental knee arthroplasty design with an all-polyethylene tibial component. Knee 2010;17:53-6.

National Joint Registry for England and Wales. In: 7th Annual Report 2010. p. 116-17.

Furnes O, Espehaug B, Lie SA, Vollset SE, Engesaeter LB, Havelin LI. Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with ce- ment. J Bone Joint Surg Am 2007;89:519-25.

Padgett DE, Stern SH, Insall JN. Revision total knee arthroplasty for failed unicompartmental replacement. J Bone Joint Surg Am 1991;73:186-90.

Barrett WP, Scott RD. Revision of failed unicondylar uni- compartmental knee arthroplasty. J Bone Joint Surg Am 1987;69:1328-35.

Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospec- tive randomised controlled trial. J Bone Joint Surg Br 2009 Jan;91:52-7.

Goodfellow JW, O'Connor JJ, Murray DW. A critique of revision rate as an outcome measure: re-interpreta- tion of knee joint registry data. J Bone Joint Surg Br 2010;92:1628-31.

Otte KS, Larsen H, Jensen TT, Hansen EM, Rechnagel K. Cementless AGC revision of unicompartmental knee arthroplasty. J Arthroplasty 1997;12:55-9.

Järvenpää J, Kettunen J, Miettinen H, Kröger H. The clini- cal outcome of revision knee replacement after unicom- partmental knee arthroplasty versus primary total knee arthroplasty: 8-17 years follow-up study of 49 patients. Int Orthop 2010;34:649-53.

Pearse AJ, Hooper GJ, Rothwell A, Frampton C. Survival and functional outcome after revision of a unicompart- mental to a total knee replacement: the New Zealand Na- tional Joint Registry. J Bone Joint Surg Br 2010;92:508- 12.

Saragaglia D, Estour G, Nemer C, Colle PE. Revision of 33 unicompartmental knee prostheses using total knee ar- throplasty: strategy and results. Int Orthop 2009;33:969- 74.

Levine WN, Ozuna RM, Scott RD, Thornhill TS. Con- version of failed modern unicompartmental arthroplasty to total knee arthroplasty. J Arthroplasty 1996;11:797- 801.

O'Donnell TM, Abouazza O, Neil MJ. Revision of mini- mal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty. J Arthroplasty 2013;28:33-9.

Sarraf KM, Konan S, Pastides PS, Haddad FS, Oussedik S. Bone loss during revision of unicompartmental to total knee arthroplasty: an analysis of implanted polyethylene thickness from the National Joint Registry data. J Arthro- plasty 2013;28:1571-4.

Saldanha KA, Keys GW, Svard UC, White SH, Rao C. Revision of Oxford medial unicompartmental knee ar- throplasty to total knee arthroplasty - results of a multi- centre study. Knee 2007;14:275-9.

Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Mur- ray DW. Minimally invasive Oxford phase 3 unicompart- mental knee replacement: results of 1000 cases. J Bone Joint Surg Br 2011;93:198-204.

Smith H, Jan M, Mahomed NN, Davey JR, Gandhi R. Meta-analysis and systematic review of clinical outcomes comparing mobile bearing and fixed bearing total knee ar- throplasty. J Arthroplasty 2011;26:1205-13.

Kim KT, Lee S, Kim TW, Lee JS, Boo KH. The influence of postoperative tibiofemoral alignment on the clinical re- sults of unicompartmental knee arthroplasty. Knee Surg Relat Res 2012;24:85-90.

The Norwegian Arthroplasty Register Report 2010. p. 57-9.

Murray DW, Pandit H, Weston-Simons JS, Jenkins C, Gill HS, Lombardi AV, et al. Does body mass index af- fect the outcome of unicompartmental knee replacement? Knee 2013;20:461-5.