Outcomes of lateral unicompartmental knee arthroplasty in post-traumatic osteoarthritis, a retrospective comparative stu
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ORIGINAL PAPER
Outcomes of lateral unicompartmental knee arthroplasty in post-traumatic osteoarthritis, a retrospective comparative study Sergio Romagnoli 1 & Jacopo Antonino Vitale 2
&
Matteo Marullo 1
Received: 19 March 2020 / Accepted: 11 June 2020 # SICOT aisbl 2020
Abstract Purpose We asked whether the clinical and radiographic outcomes and survivorship after unicompartmental knee arthroplasty (UKA) for osteoarthritis (OA) consequent to lateral tibial plateau fracture were comparable with those obtained after lateral UKA for primary OA. Methods A total of 13 patients receiving lateral UKA for OA secondary to tibial plateau fracture (post-traumatic UKA, P-UKA) were compared with 13 patients who underwent lateral UKA for primary OA (OA-UKA). Patients were matched for age at surgery, gender, body mass index, and follow-up length. Pre- and post-operative clinical and radiographic assessments included clinical (KSS-c) and functional (KSS-f) Knee Society Score, Hip-Knee-Ankle (HKA) angle, and signs of osteolysis. Results Mean follow-up was similar in both groups: 9.9 ± 4.6 years for P-UKA and 9.3 ± 2.4 years for OA-UKA. The two way ANOVA procedure followed by the Bonferroni multiple comparisons test highlighted a baseline difference in KSS-c with PUKA having greater scores than OA-UKA (+ 12; p < 0.05) and both groups showed large improvements in KSS-c (p < 0.001), KSS-f (p < 0.001), and HKA angle (p < 0.001) at follow-up. The nine year prosthesis survival rate, tested by the Kaplan-Meier methods, was 92% in both groups. Conclusion Lateral UKA for OA secondary to tibial plateau fracture was efficient in restoring joint function, improving clinical results, and correcting lower limb alignment. Clinical outcomes and nine year survivorship did not differ from lateral UKA for primary OA. Consequently, lateral UKA should be considered a valid option in treating lateral posttraumatic OA in carefully selected patients. Trial registration number (clinicaltrials.gov) NCT04198389 Keywords Lateral unicompartmental knee replacement . Post-traumatic osteoarthritis . Tibial plateau fracture . Knee osteoarthritis . Knee replacement
Introduction Fractures of the tibial plateau are relatively common orthopaedic injuries, and they can frequently trigger the development of post-traumatic osteoarthritis (OA) of the knee. Since tibial plateau fractures frequently occur in young patients, many are prone to develop post-traumatic end-stage OA at an early age,
* Jacopo Antonino Vitale [email protected] 1
Joint Replacement Department, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
2
LaMSS – Laboratory of Movement and Sport Science, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
when the functional demand for work or recreational activities is still high. Tibial plateau fractures occur due to a combination of valgus and axial forces to the knee that result in damage to the lateral tibial plateau more often than to the medial plateau [1]. Total knee arthropla
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