The Effect of Correction Amount of Varus Deformity After Unicompartmental Knee Arthroplasty on Functional and Clinical Outcomes

Yıl 2024, Cilt: 15 Sayı: 3, 447 - 453, 25.12.2024

Meric Unal , Necmettin Turgut , Bahattin Baykal , Sabriye Ercan , Nur Kara Oğuz

https://doi.org/10.22312/sdusbed.1447756

Öz

Objective: This study aimed to investigate the impact of varus deformity correction on functional and clinical outcomes following unicompartmental knee surgery.

Materials and Methods: A total of 71 medial unicompartmental knee arthroplasties (UKA) in 51 patients were included in this study. The knees were categorized based on the degree of correction observed in standing orthoroentgenograms post-surgery (Group 1: 0-4.9° correction, Group 2: 5-9.9° correction, and Group 3: 10° or more correction). Functional knee evaluation was assessed using range of motion measurements, posterior tibial slope angles, visual analogue score (VAS), Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Knee Score (OKS) questionnaires.

Results: Following UKA surgery, there was a significant improvement in all patient-reported outcome scores, posterior tibial slope angles, visual analogue scores, and range of motion measurements across all groups. However, no significant differences were observed when comparing postoperative scores between the groups.

Conclusion: Patients with varus deformities of up to 15 degrees can safely undergo UKA surgery without compromising clinical and functional outcomes.

Anahtar Kelimeler

unicompartmental knee replacement, varus deformity, tibial slope

Proje Numarası

16 /11/2017 tarih ve 218 sayılı

Unikompartmental Diz Artroplastisi Sonrası Varus Deformite Düzeltme Miktarının Fonksiyonel ve Klinik Sonuçlar Üzerine Etkisi

Öz

Amaç: Bu çalışmanın amacı, unicompartmental diz cerrahisi sonrası varus deformite düzeltiminin fonksiyonel ve klinik sonuçlar üzerindeki etkisini araştırmaktır.
Gereç ve Yöntem: Bu çalışmaya 51 hastada 71 medial unicompartmental diz artroplastisi (UKA) dahil edildi. Dizler, ameliyat sonrası ayakta çekilen ortoröntgenogramlarda gözlenen düzeltme derecesine göre gruplandırıldı (Grup 1: 0-4.9° düzeltme, Grup 2: 5-9.9° düzeltme ve Grup 3: 10° veya daha fazla düzeltme). Fonksiyonel diz değerlendirmesi, hareket açıklığı ölçümleri, posterior tibial eğim açıları, görsel analog skor (VAS), Knee Society Skoru (KSS), Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC) ve Oxford Diz Skoru (OKS) anketleri kullanılarak yapıldı.
Bulgular: UKA cerrahisi sonrası, tüm gruplarda tüm hasta bildirilen sonuç skorlarında, posterior tibial eğim açılarında, görsel analog skorlarda ve hareket açıklığı ölçümlerinde önemli bir iyileşme görüldü. Ancak, gruplar arasında postoperatif skorları karşılaştırırken anlamlı farklar gözlenmedi.
Sonuç: 15 dereceye kadar varus deformitesi olan hastalarda klinik ve fonksiyonel sonuçlar açısından güvenle UKA cerrahisi uygulanabilir.

Anahtar Kelimeler

varus deformitesi, tibial eğim, unikompartmental diz replasmanı

Etik Beyan

16 /11/2017 tarih ve 218 sayılı etik kurul onayı SDÜ etik kurulundan alınmıştır.

Destekleyen Kurum

-

Proje Numarası

16 /11/2017 tarih ve 218 sayılı

Teşekkür

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Kaynakça

• 1. Kennedy WR, White RP. Unicompartmental arthroplasty of the knee: postoperative alignment and its influence on overall results. Clin Orthop Relat Res. 1987 Aug;(221):278–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3608312
• 2. Hernigou P, Deschamps G. Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2004 Jun;(423):161–5. Available from: http://journals.lww.com/00003086-200406000-00026
• 3. Koshino T, Morii T, Wada J, Takahashi S. Unicompartmental replacement with the Marmor modular knee: operative procedure and results. Bull Hosp Jt Dis Orthop Inst. 1991;51(2):119–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1666002
• 4. Kuipers BM, Kollen BJ, Kaijser Bots PC, Burger BJ, van Raay JJAM, Tulp NJA, et al. Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee. 2010 Jan;17(1):48–52. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0968016009001197
• 5. Berend KR, Salin JW, Lombardi AV. Unicondylar knee arthroplasty. Oper Tech Adult Reconstr Surg. 2012 Jan;71(1):152–61. Available from: http://journals.lww.com/00004623-198971010-00023
• 6. White SH, Roberts S, Kuiper JH. The cemented twin-peg Oxford partial knee replacement survivorship: a cohort study. Knee. 2015 Sep;22(4):333-337. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0968016015000630
• 7. Kreitz TM, Maltenfort MG, Lonner JH. The valgus stress radiograph does not determine the full extent of correction of deformity prior to medial unicompartmental knee arthroplasty. J Arthroplasty. 2015 Jul;30(7):1233–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0883540315001199
• 8. Waldstein W, Monsef JB, Buckup J, Boettner F. The value of valgus stress radiographs in the workup for medial unicompartmental arthritis. Clin Orthop Relat Res. 2013 Dec;471(12):3998–4003. Available from: http://link.springer.com/10.1007/s11999-013-3212-3
• 9. Seng CS, Ho DC, Chong HC, Chia SL, Chin PL, Lo NN, et al. Outcomes and survivorship of unicondylar knee arthroplasty in patients with severe deformity. Knee Surg Sports Traumatol Arthrosc. 2017 Mar;25(3):639–44. Available from: http://link.springer.com/10.1007/s00167-014-3464-9
• 10. Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A. Minor varus alignment provides better results than neutral alignment in medial UKA. Knee. 2015 Mar;22(2):117–21. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0968016014002877
• 11. Kennedy JA, Molloy J, Jenkins C, Mellon SJ, Dodd CAF, Murray DW. Functional outcome and revision rate are independent of limb alignment following Oxford medial unicompartmental knee replacement. J Bone Jt Surg. 2019 Feb;101(3):270–5. Available from: http://journals.lww.com/00004623-201902060-00009
• 12. Zuiderbaan HA, van der List JP, Chawla H, Khamaisy S, Thein R, Pearle AD. Predictors of subjective outcome after medial unicompartmental knee arthroplasty. J Arthroplasty. 2016 Jul;31(7):1453–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S088354031600005X
• 13. Kleeblad LJ, van der List JP, Pearle AD, Fragomen AT, Rozbruch SR. Predicting the feasibility of correcting mechanical axis in large varus deformities with unicompartmental knee arthroplasty. J Arthroplasty. 2018 Feb;33(2):372–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0883540317308549
• 14. Jeer PJS, Keene GCR, Gill P. Unicompartmental knee arthroplasty: an intermediate report of survivorship after the introduction of a new system with analysis of failures. Knee. 2004 Oct;11(5):369–74. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0968016004001292
• 15. Gulati A, Pandit H, Jenkins C, Chau R, Dodd CAF, Murray DW. The effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br. 2009 Apr;91-B(4):469–74. Available from: http://online.boneandjoint.org.uk/doi/10.1302/0301-620X.91B4.22105
• 16. Citak M, Dersch K, Kamath AF, Haasper C, Gehrke T, Kendoff D. Common causes of failed unicompartmental knee arthroplasty: a single-centre analysis of 471 cases. Int Orthop. 2014;38(5):961–5.
• 17. John J, Kuiper JH, May PC. Age at follow-up and mechanical axis are good predictors of function after unicompartmental knee arthroplasty: an analysis of patients over 17 years follow-up. Acta Orthop Belg. 2009 Feb;75(1):45–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19358398
• 18. Baker P, Jameson S, Critchley R, Reed M, Gregg P, Deehan D. Center and surgeon volume influence the revision rate following unicondylar knee replacement: an analysis of 23,400 medial cemented unicondylar knee replacements. J Bone Jt Surg Am. 2013 Apr;95(8):702–9. Available from: http://journals.lww.com/00004623-201304170-00005