Abstract
When unicompartmental knee arthroplasty (UKA) failure occurs, a revision procedure to total knee arthroplasty (TKA) is often necessary. We compared the long-term results of this procedure to primary TKA and evaluated whether they are clinically comparable. Twenty-one patients underwent UKA conversion to TKA between 1991 and 2000. The results of these patients were compared to the group of 28 primary TKA patients with the same age, sex and operation time point. The long-term outcomes were evaluated using clinical and radiological analysis. The mean follow-up period of the patients was 10.5 years. The UKA revision patients were more dissatisfied, as measured by the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scale (0–100 mm) compared to the primary TKA patients (pain 18.1/7.8; p = 0.014; stiffness 25.7/14.4, p = 0.024; physical function 19.0/14.8, p = 0.62). Two patients were revised twice in the UKA revision group. There was one revision in the primary TKA group (p = 0.39). Improvement in range of motion (ROM) was better in the TKA patients compared to the UKA revision patients (8.2°/–2.6°, p = 0.0001). We suggest that UKA conversion to TKA is associated with poorer clinical outcome as compared to primary TKA.
Similar content being viewed by others
References
Barret WP, Scott RD (1987) Revision of failed unicondylar arthroplasty. J Bone Joint Surg Am 69:1328–1335
Bellamy N, Buchanan WW, Goldsmith CH, Campbell C, Stitt LW (1988) Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840
Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 87:999–1006
Bray GA (1987) Overweight is risking fate: definition, classification, prevalence and risks. Ann NY Acad Sci 9:14–29
Böhm I, Landsiedl F (2000) Revision surgery after failed unicompartmental knee arthroplasty. A study of 35 cases. J Arthroplasty 15:982–989
Chakrabarty G, Newman JH, Ackroyd CE (1998) Revision of unicompartmental arthroplasty of the knee. Clinical and technical considerations. J Arthroplasty 13:191–196
Dudley TE, Gioe TJ, Sinner P, Mehle S (2008) Registry outcomes of unicompartmental knee arthroplasty revisions. Clin Orthop Relat Res 466:1666–1670
Gioe TJ, Novak C, Sinner P, Ma W, Mehle S (2007) Knee arthroplasty in the young patient: survival in a community registry. Clin Orthop Relat Res 464:83–87
Griffin T, Rowden N, Morgan D, Atkinson R, Woodruff P, Maddern G (2007) Unicompartmental knee arthroplasty for the treatment of unicompartmental osteoarthritis: A systematic study. ANZ J Surg 77:214–221
Harrysson OL, Robertsson O, Nayfeh JF (2004) Higher cumulative revision rate of knee arthroplasties in younger patients with osteoarthritis. Clin Orthop Relat Res 421:162–168
Insall J, Walker P (1976) Unicondylar knee replacement. Clin Orthop Relat Res 120:83–85
Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V (2007) Unicondylar knee replacement for primary osteoarthritis. A prospective follow-up study of 1,819 patients from the finnish arthroplasty register. Acta Orthop 78:128–135
Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis. A follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop 79:499–507
Kostuik JP, Schmidt O, Harris WR, Wooldridge C (1975) A study of weight transmission through the knee joint with applied varus and valgus loads. Clin Orthop Relat Res 108:95–98
Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71:145–150
Levine WN, Ozuna RM, Scott RD, Thornhill TS (1996) Conversion of failed modern unicompartmental arthroplasty to total knee arthroplasty. J Arthroplasty 11:797–801
Luscombe KL, Lim J, Jones PW, White SH (2007) Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! Int Orthop 31:321–324
Mathias S, Nayak U, Isaacs B (1986) Balance in elderly patients. The “get-up and go” test. Arch Phys Med Rehabil 67:387–389
Miller M, Benjamin JB, Marson B, Hollstien S (2002) The effect of implant constraint on results of conversion of unicompartmental knee arthroplasty to total knee arthroplasty. Orthopedics 25:1353–1357
Murray DW, Goodfellow JW, O' Connor JJ (1998) The Oxford medial unicompartmental arthroplasty. A ten-year survival study. J Bone Joint Surg Br 80:983–989
Robertsson O, Borgquist L, Knutson K, Lewold S, Lindgren L (1999) Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses. Acta Orthop Scand 70:170–175
Saragaglia D, Estour G, Nemer C, Colle PE (2008) Revision of 33 unicompartmental knee prostheses using total knee arthroplasty: strategy and results. Int Orthop. doi:10.1007/s00264-008-0585-0
Skolnick MD, Bryan RS, Peterson LF (1975) Unicompartmental polycentric knee arthroplasty: description and preliminary results. Clin Orthop Relat Res 112:208–214
Soohoo NF, Sharifi H, Kominski G, Lieberman JR (2006) Cost-effectiveness analysis of unicompartmental knee arthroplasty as an alternative to total knee arthroplasty for unicompartmental osteoarthritis. J Bone Joint Surg Am 88:1975–1982
Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84(Suppl 2):90–98
Tabor OW Jr, Tabor OW (1998) Unicompartmental arthroplasty. A long-term follow-up study. J Arthroplasty 13:373–379
Walton P, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Järvenpää, J., Kettunen, J., Miettinen, H. et al. The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients. International Orthopaedics (SICOT) 34, 649–653 (2010). https://doi.org/10.1007/s00264-009-0811-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-009-0811-4