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. 2023 Sep;143(9):5849-5856.
doi: 10.1007/s00402-023-04841-x. Epub 2023 Mar 14.

Short- to mid-term results of minimally invasive lateral unicompartmental knee replacement: 133 cases in a non-designer series

Mustafa Hariri  1 , Merlin Hagemann  1 , Kevin-Arno Koch  1 , Tobias Reiner  1 , Benjamin Panzram  1 , Christian Merle  1 , Tobias Renkawitz  1 , Tilman Walker  2
Affiliations

Short- to mid-term results of minimally invasive lateral unicompartmental knee replacement: 133 cases in a non-designer series

Mustafa Hariri et al. Arch Orthop Trauma Surg. 2023 Sep.

Abstract

Introduction: The aim of the current study was to demonstrate short- to mid-term survivorship as well as clinical outcome of lateral unicompartmental knee replacement (UKR) with a fixed-bearing (FB) design from a non-designer center using the Oxford Fixed Lateral prosthesis.

Materials and methods: This single-center retrospective cohort study reports the results of 133 consecutive lateral FB-UKR. Survivorship analysis was performed with different endpoints and clinical outcome was measured using the Oxford-Knee-Score (OKS), American-Knee-Society-Score (AKSS-O), range-of-motion (ROM) and visual-analog-scale for pain (VAS).

Results: There were two revision surgeries with conversion to total knee replacements (TKR) due to persistent pain resulting in a survival rate of 98.5% (95% CI 93.5-99.6) with a mean follow-up (FU) of 3.3 ± 1.8 years (range 1-8.5). All outcome scores, VAS and ROM showed a significant improvement at final FU (p < 0.001). The OKS improved from 26 ± 7.8 (range 11-45) preoperatively to 39 ± 8.3 (range 13-48), the AKSS-O from 49.2 ± 14.6 (range 18-90) to 81.8 ± 15.1 (range 40-100), the AKSS-F from 53 ± 23.7 (range 0-100) to 80.4 ± 21.4 (range 5-100) and the ROM from 118 ± 17 (range 90-160) to 134 ± 9.5 (range 100-155).

Conclusions: The short- to mid-term results following lateral FB-UKR demonstrate a high survivorship and good clinical outcome from an independent series. We, therefore, suggest that FB-UKR is a safe treatment option for isolated lateral OA if sufficient surgical experience is provided.

Level of evidence: Retrospective cohort study, level IV.

Keywords: Fixed bearing; Lateral unicompartmental knee replacement; Partial knee arthroplasty; UKA; UKR.

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Conflict of interest statement

The Author TR has received research support and personal fees from Arbeitsgemeinschaft Endoprothetik (AE), DGOU, DGOOC, BVOU, DePuy International, Otoo Bock Foundation, Deutsche Arthrose Hilfe, Aesculap, Zimmer, Stiftung Oskar Helene Heim Berlin, Vielberth Foundation Regensburg, the German Ministry of Education and Research as well as the German Federal Ministry of Economic Cooperation and Development not directly related to this study. The Author BP has received institutional grants from Zimmer Biomet not directly related to this study. The Author CM has received institutional financial support from Zimmer Biomet, Medacta, Depuy and Johnson & Johnson not directly related to this study. Furthermore, he has received author payments from Thieme. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survivorship curve with 95% confidence interval (CIs) (thin continuous lines) for “revision for any reason” as the endpoint. The 3-year survival was estimated at 98.5% (95% CI 93.5–99.6); dashed line presents mean follow-up timepoint of 3.3 years
Fig. 2
Fig. 2
Kaplan–Meier survivorship curve with 95% confidence interval (CI) (thin continuous lines) for “reoperation” as the endpoint. The 3-year survival was estimated at 96.2% (95% CI 91.7–98.5); dashed line presents mean follow-up timepoint of 3.3 years
Fig. 3
Fig. 3
Clinical outcome scores, range-of-motion and visual-analogue-scale for pain preoperatively and at minimum 12 months follow-up. The differences were statistically significant (p < 0.001). OKS Oxford Knee Score, AKSS-O Objective American Knee Society Score, AKSS-F Functional American Knee Society Score, ROM range-of-motion, VAS Visual-analogue-scale for pain
See this image and copyright information in PMC

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