Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty

Cheol Hee Park; Ho Jin Lee; Hyuck Sung Son; Dae Kyung Bae; Sang Jun Song

doi:10.4055/jkoa.2019.54.5.427

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Park, Lee, Son, Bae, and Song: Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association 2019; 54(5): 427-434.

Published online: 30 October 2019

DOI: https://doi.org/10.4055/jkoa.2019.54.5.427

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty

Cheol Hee Park, M.D., Ho Jin Lee, M.D., Hyuck Sung Son, M.D., Dae Kyung Bae, M.D.^*, Sang Jun Song, M.D.

Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Korea.

^*Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.

Correspondence to: Sang Jun Song, M.D. Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. TEL: +82-2-958-9489, FAX: +82-2-964-3865, tesstore@empas.com

Received 19 August 2018 Revised 6 November 2018 Accepted 29 November 2018

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors.

Materials and Methods

Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan–Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan–Meier survival curves were compared according to the factors affecting the survival of UKA.

Results

The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025).

Conclusion

The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

Keywords: knee, arthroplasty, unicompartmental, survival

Figures and Tables

Figure 1

Overall survival curve of unicompartmental knee arthroplasty.

Figure 2

Survival curve according to the patient's age.

Figure 3

Survival curve according to the implants. Significant difference between the survival curve (^*p=0.029, ^†p=0.049).

Table 1

Demographic Parameters of the Patients

Values are presented as median (range) or number only. OA:2° OA:ON, osteoarthris:secondary osteoarthritis:osteonecrosis.

Table 2

Demographic Parameters of the Patients according to the Implants

Values are presented as number only, range only, or median (range).

Table 3

Cox Regression Analysis

Table 4

Comparison of Clinical and Radiological Results according to Age

Values are presented as mean±standard deviation.

Table 5

Comparison of Clinical and Radiological Results according to the Impalnts

Values are presented as mean±standard deviation. ^*Varus

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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ORCID iDs: Sang Jun Song
https://orcid.org/0000-0003-4440-9791
Similar articles

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty

Abstract

Purpose

Materials and Methods

Results

Conclusion

Figures and Tables

Figure 1

Overall survival curve of unicompartmental knee arthroplasty.

Figure 2

Survival curve according to the patient's age.

Figure 3

Survival curve according to the implants. Significant difference between the survival curve (*p=0.029, †p=0.049).

Table 1

Demographic Parameters of the Patients

Table 2

Demographic Parameters of the Patients according to the Implants

Table 3

Cox Regression Analysis

Table 4

Comparison of Clinical and Radiological Results according to Age

Table 5

Comparison of Clinical and Radiological Results according to the Impalnts

Notes

References

Survival curve according to the implants. Significant difference between the survival curve (^*p=0.029, ^†p=0.049).