Incidence of Bicompartmental Osteoarthritis in Patients Undergoing Total and Unicompartmental Knee Arthroplasty: Is the Time Ripe for a Less Radical Treatment?

Richard David Heekin; Alexander A. Fokin

doi:10.1055/s-0033-1349401

The Journal of Knee Surgery, Inhaltsverzeichnis

J Knee Surg 2014; 27(01): 077-082
DOI: 10.1055/s-0033-1349401

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Incidence of Bicompartmental Osteoarthritis in Patients Undergoing Total and Unicompartmental Knee Arthroplasty: Is the Time Ripe for a Less Radical Treatment?

Richard David Heekin

¹Heekin Orthopedic Specialists, St. Vincent's Medical Center, Jacksonville, Florida

,

Alexander A. Fokin

²Department of Research, Heekin Institute for Orthopedic Research, Jacksonville, Florida

› Institutsangaben

Abstract

We sought to determine the incidence of bicompartmental osteoarthritis among knee replacement patients for possible bone-sparing procedures. In 259 consecutive Knee Registry subjects undergoing total or unicondylar knee arthroplasty, all three compartments of the knee joint were evaluated. Radiographic images and preoperative cruciate ligaments assessment combined with intraoperative cartilage grading using Outerbridge classification was implemented for patients' evaluations. Among the candidates for knee replacement arthroplasty, 59% had osteoarthritis in all three compartments, 28% had bicompartmental disease, and 4% had unicompartmental disease. Nine percent of patients exhibited inconclusive osteoarthritis pattern. Only 5% of the patients were found to have cruciate ligaments impairment. Older patients ( > 65 years) were significantly more likely to have bi- and tricompartmental disease. We had found that 28% of our registry population had bicompartmental disease and infrequent impairment of cruciate ligaments, indicating that between one-fourth and one-third of patients undergoing total knee arthroplasty could be considered for bone preserving bicompartmental knee arthroplasty.

Keywords

bicompartmental osteoarthritis - bone-sparing arthroplasty

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Referenzen

References
1 Beard DJ, Pandit H, Ostlere S, Jenkins C, Dodd CAF, Murray DW. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg Br 2007; 89 (12) 1602-1607
2 Kang SN, Smith TO, Sprenger De Rover WB, Walton NP. Pre-operative patellofemoral degenerative changes do not affect the outcome after medial Oxford unicompartmental knee replacement: a report from an independent centre. J Bone Joint Surg Br 2011; 93 (4) 476-478
3 Pandit H, Beard DJ, Jenkins C , et al. Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthroplasty. J Bone Joint Surg Br 2006; 88 (7) 887-892
4 Rolston L, Bresch J, Engh G , et al. Bicompartmental knee arthroplasty: a bone-sparing, ligament-sparing, and minimally invasive alternative for active patients. Orthopedics 2007; 30 (8)) (Suppl): 70-73
5 Fridén T, Roberts D, Ageberg E, Waldén M, Zätterström R. Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture. J Orthop Sports Phys Ther 2001; 31 (10) 567-576
6 Dhillon MS, Bali K, Prabhakar S. Proprioception in anterior cruciate ligament deficient knees and its relevance in anterior cruciate ligament reconstruction. Indian J Orthop 2011; 45 (4) 294-300
7 Newman JH, Ackroyd CE, Shah NA. 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 1998; 80 (5) 862-865
8 Laurencin CT, Zelicof SB, Scott RD, Ewald FC. Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res 1991; (273) 151-156
9 Rupprecht TN, Oczipka F, Lüring C, Pennekamp PH, Grifka J. Is there a correlation between the clinical, radiological and intrasurgical findings of osteoarthritis of the knee? A Prospective study on 103 patients. Z Orthop Unfall 2007; 145 (4) 430-435
10 Duncan RC, Hay EM, Saklatvala J, Croft PR. Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology (Oxford) 2006; 45 (6) 757-760
11 Ledingham J, Regan M, Jones A, Doherty M. Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital. Ann Rheum Dis 1993; 52 (7) 520-526
12 Outerbridge RE, Dunlop JA. The problem of chondromalacia patellae. Clin Orthop Relat Res 1975; 110 (110) 177-196
13 Cameron ML, Briggs KK, Steadman JR. Reproducibility and reliability of the outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med 2003; 31 (1) 83-86
14 Centers for Disease Control and Prevention (CDC). Prevalence of disabilities and associated health conditions among adults—United States, 1999. MMWR Morb Mortal Wkly Rep 2001; 50 (7) 120-125
15 Ritter MA, Faris PM, Thong AE, Davis KE, Meding JB, Berend ME. Intra-operative findings in varus osteoarthritis of the knee. An analysis of pre-operative alignment in potential candidates for unicompartmental arthroplasty. J Bone Joint Surg Br 2004; 86 (1) 43-47
16 Thomas RH, Resnick D, Alazraki NP, Daniel D, Greenfield R. Compartmental evaluation of osteoarthritis of the knee. A comparative study of available diagnostic modalities. Radiology 1975; 116 (3) 585-594
17 Rodrigez-Merchan EC, Gomez-Cordero P. The Outerbridge Classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res 2010; 468: 1254-1257
18 Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 35-43
19 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (1) 57-63
20 Suda AJ, Seeger JB, Bitsch RG, Krueger M, Clarius M. Are patients' expectations of hip and knee arthroplasty fulfilled? A prospective study of 130 patients. Orthopedics 2010; 33 (2) 76-80
21 Dalury DF, Fisher DA, Adams MJ, Gonzales RA. Unicompartmental knee arthroplasty compares favorably to total knee arthroplasty in the same patient. Orthopedics 2009; 32 (4) pii
22 Leffler J, Scheys L, Planté-Bordeneuve T , et al. Joint kinematics following bi-compartmental knee replacement during daily life motor tasks. Gait Posture 2012; 36 (3) 454-460
23 Wang H, Frame J, Rolston L. Influence of bicompartmental knee replacement on stand-to-sit movement. Res Q Exerc Sport 2012; 83 (2) 136-142
24 Palumbo BT, Henderson ER, Edwards PK, Burris RB, Gutiérrez S, Raterman SJ. Initial experience of the Journey-Deuce bicompartmental knee prosthesis: a review of 36 cases. J Arthroplasty 2011; 26 (6) (Suppl): 40-45
25 Morrison TA, Nyce JD, Macaulay WB, Geller JA. Early adverse results with bicompartmental knee arthroplasty: a prospective cohort comparison to total knee arthroplasty. J Arthroplasty 2011; 26 (6)) (Suppl): 35-39
26 Thienpont E, Price A. Bicompartmental knee arthroplasty of the patellofemoral and medial compartments. Knee Surg Sports Traumatol Arthrosc 2012;
27 Müller M, Matziolis G, Falk R, Hommel H. The bicompartmental knee joint prosthesis Journey Deuce: failure analysis and optimization strategies. Orthopade 2012; 41 (11) 894-904
28 Naziri Q, Pivec R, Johnson AJ , et al. New technologies in knee arthroplasty. Surg Technol Int 2012; XXII (1) xxii