2023 ISAKOS Biennial Congress ePoster
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty
James Gill, MB BChir, BSc, FRCS, Cambridge, Cambridge UNITED KINGDOM
McMeniman J Peter, Brisbane, Qld AUSTRALIA
Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, Brisbane, QLD AUSTRALIA
Daniel Johnson Brimm, BSc, MD, Rockhampton AUSTRALIA
Peter T. Myers, AM, MBBS, FRACS, FAOrthA, Brisbane, QLD AUSTRALIA
Brisbane Orthopaedic and Sports Medicine Centre, Brisbane, Queensland, AUSTRALIA
FDA Status Cleared
Summary
Per-operative arthroscopy may improve short- to medium-term medial unicompartmental knee survivorship but did not improve long-term survivorship nor reduce revision due to progression of arthritis in this series.
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Abstract
Introduction
Patient selection is key to the success of medial unicondylar knee arthroplasty (UKA). Progression of arthritis is the most common indication for revision surgery. Various methods of assessing the lateral compartment have been used including stress radiography, radioisotope bone scanning, magnetic resonance imaging, and visualisation at the time of surgery. Arthroscopy is another means of directly assessing the integrity of the lateral compartment.
Purpose
The aim of the study is to assess the long-term survivorship of UKA performed when per-operative arthroscopy is used as a final means of deciding whether to proceed with UKA.
Methods
We used per-operative arthroscopy as a means to confirm suitability for UKA in a consecutive series of 279 Oxford medial UKA. This study reports the long-term results of a previously published cohort of knees. Our series of UKA with per-operative arthroscopy (Group 1) was compared to all Oxford UKA (Group 2) and all UKA in the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) (Group 3).
Results
The 14-year cumulative percentage revision (CPR) was 18.5% (95% CI 12.7, 26.4) for group 1, 19.7% (95% CI 18.8, 20.6) for group 2, and 19.2% (95% CI 18.5, 19.8) for group 3. There was no statistically significant difference in the (CPR) for the entire period when group 1 was compared to groups 2 or 3. Progression of arthritis was the indication for revision in similar proportions for the three groups (Group 1: 32.3%, Group 2: 35.7% and Group 3: 33.5%). Following per-operative arthroscopy 21.6% (77/356) of knees underwent a change of surgical plan from UKA to TKA.
Conclusion
Per-operative arthroscopy may improve short- to medium-term medial unicompartmental knee survivorship but does not improve long-term survivorship nor reduce revision due to progression of arthritis.