Summary: Preoperative subchondral BME was related to adverse postoperative clinical outcomes, however, it did not negatively influence survival rates at long-term follow-up. UKA yielded good survival rates at a mean follow-up of 9.8 years regardless of BME severity.

Background

To investigate the association between extent of subchondral bone marrow edema (BME) as classified by magnetic resonance imaging (MRI) and intermediate to long-term outcomes after unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis.

Methods

We enrolled 150 knees (144 patients) that underwent fixed-bearing UKA between April 2003 and December 2014 with a minimum follow-up of 5 years; the mean overall follow-up duration was 9.8 years (5.1 to 17.7 years). We divided the patients into two groups based on the presence or absence of preoperative BME. Patients were also subdivided into four groups according to their BME scores determined by the MRI Osteoarthritis Knee Score (MOAKS) method. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Forgotten Joint Score. Furthermore, survival rates and relevant risk factors that affect joint survivorship were analyzed.

Results

The groups with BME demonstrated significantly worse postoperative WOMAC pain and Forgotten Joint Scores at the final follow-up than the group without BME. (all p < 0.05). We also found significant differences among the scores of groups with different BME grades (all p < 0.05). Post hoc analysis demonstrated differences between groups 1 and 2, 1 and 3, 1 and 4, and 2 and 4 (all p < 0.05) with a significant correlation between postoperative clinical outcome and the extent of BME (r = 0.430 [WOMAC pain], r = -0.342 [Forgotten Joint Score]; p < 0.05). The survival rate was 95.4% at a mean period of 9.8 years, and survival was not associated with the presence of BME (p = 0.232; log-rank test).

Conclusion

In the intermediate to long-term follow up, preoperative BME negatively impacted the clinical outcomes after UKA, although UKA contributed to excellent survival rates after a mean follow-up of 9.8 years regardless of BME severity.

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Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, CANADA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA ePoster Presentation Manabu Akagawa, MD, PhD, JAPAN ヒデトモサイトウ, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MS , INDIA Farheen Khan, B.Tech, INDIA
Participation of Physical Activity Following Knee Arthroplasty: A Meta-Analysis ePoster Presentation Ahmed A Magan, BM BSc (Hons) MRCS (Eng) FRCS (Eng) Trauma & Orth, UNITED KINGDOM Babar Kayani, BSc (HONS), MBBS, MRCS (Eng), UNITED KINGDOM Warran Wignadasan, MBBS, BSc (Hons), MRCS, UNITED KINGDOM Dia Eldean Giebaly, MBChB, MSc, FRCS, EMBA, UNITED KINGDOM Flaminia Ronca, PHD, UNITED KINGDOM Fares S. Haddad, MCh(Orth), BSc, FRCS(Orth), UNITED KINGDOM

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Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty

Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty

Background

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Conclusion

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Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty

Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty

Background

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content