Arthroplasty today · 2022
Presence of a Lateral Trochlear Osteophyte Predicts Medial Unicompartmental Arthroplasty Failure at Midterm Follow-up.
СтатьяНазвание и аннотация: Перевод в очереди
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Carender Christopher N, Rand Dayton R, DeMik David E, An Qiang, Noiseux Nicolas O
Аннотация
BACKGROUND: Specific clinical and radiographic risk factors for medial unicompartmental knee arthroplasty (UKA) failure are incompletely understood. The purpose of this study was to perform a midterm survivorship analysis of medial UKA from a single, nondesigner surgeon. Based on observations from clinical practice, we hypothesized that the presence of a lateral trochlear osteophyte on preoperative Merchant radiographs may be predictive of medial UKA failure secondary to progressive osteoarthritis (OA).
METHODS: Patients who underwent a mobile-bearing medial UKA by a single surgeon with minimum 24 months of clinical follow-up from 2008 to 2019 were retrospectively identified. Radiographic parameters, including the presence of a lateral trochlear osteophyte, were measured. Kaplan-Meier survivorship analyses were performed. Cox proportional hazards models were used to evaluate variables as risk factors for UKA failure, defined as reoperation or component revision.
RESULTS: A total of 233 UKAs were included. The mean age was 60 years, mean BMI 32 kg/m2, and 53% of patients were male. The mean follow-up duration was 5.7 years (range, 2.0-13.1 years). Using any reoperation as an endpoint, the 10-year survival was 91%. Using any component revision as an endpoint, the 10-year survival was 93%. Using revision due to progressive OA as an endpoint, the 10-year survival was 95%. The presence of a lateral trochlear osteophyte was associated with an increased risk of any reoperation (hazard ratio 3.6; 95% confidence interval 1.3-9.5) and increased risk of revision due to progressive OA (hazard ratio 9.8; 95% confidence interval 2.9-32.7).
CONCLUSIONS: The presence of a lateral trochlear osteophyte on preoperative Merchant view radiographs was associated with an increased risk of medial UKA failure.
METHODS: Patients who underwent a mobile-bearing medial UKA by a single surgeon with minimum 24 months of clinical follow-up from 2008 to 2019 were retrospectively identified. Radiographic parameters, including the presence of a lateral trochlear osteophyte, were measured. Kaplan-Meier survivorship analyses were performed. Cox proportional hazards models were used to evaluate variables as risk factors for UKA failure, defined as reoperation or component revision.
RESULTS: A total of 233 UKAs were included. The mean age was 60 years, mean BMI 32 kg/m2, and 53% of patients were male. The mean follow-up duration was 5.7 years (range, 2.0-13.1 years). Using any reoperation as an endpoint, the 10-year survival was 91%. Using any component revision as an endpoint, the 10-year survival was 93%. Using revision due to progressive OA as an endpoint, the 10-year survival was 95%. The presence of a lateral trochlear osteophyte was associated with an increased risk of any reoperation (hazard ratio 3.6; 95% confidence interval 1.3-9.5) and increased risk of revision due to progressive OA (hazard ratio 9.8; 95% confidence interval 2.9-32.7).
CONCLUSIONS: The presence of a lateral trochlear osteophyte on preoperative Merchant view radiographs was associated with an increased risk of medial UKA failure.