Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty
Aims: Valgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes. Methods: This prospecti...
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The British Editorial Society of Bone & Joint Surgery
2025-02-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0161.R1 |
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| author | Alexander Gallant Pieter-Jan Vandekerckhove Lucas Beckers Arne De Smet Cedric Depuydt Jan Victor François Hardeman |
| author_facet | Alexander Gallant Pieter-Jan Vandekerckhove Lucas Beckers Arne De Smet Cedric Depuydt Jan Victor François Hardeman |
| author_sort | Alexander Gallant |
| collection | DOAJ |
| description | Aims: Valgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes. Methods: This prospective multicentre study analyzed 97 knees from 90 patients undergoing UKA across four participating hospitals. A standardized surgical technique was employed uniformly by all participating surgeons. Postoperative evaluations were conducted preoperatively, and one day, four weeks, three months, and one year postoperative, encompassing weightbearing radiographs, bone mineral density assessments, and clinical outcome reports using the Forgotten Joint Score and Oxford Knee Score. Statistical analyses, including non-parametric correlation analysis using the Kendall correlation coefficient and Mann-Whitney U test, were performed to explore associations between subsidence and various patient-related or radiological parameters. Results: A total of eight patients showed more than 2° valgus subsidence (8.2%), higher than previously reported rates. There were significant correlations between subsidence and higher preoperative varus alignment of the tibia, larger adaptation of the preoperative varus to a postoperative neutral or valgus alignment, mediolateral undersizing of the tibial component, excessive lateral load of tibial component by more lateral position of femoral component relative to tibial component, a lower T-score, and female sex. Our study found no significant difference in pain scores between subsidence and non-subsidence groups at various postoperative milestones. Conclusion: These findings corroborate earlier suggested risk factors based on biomechanical models. Further research might provide the opportunity to identify high-risk groups preoperatively and adapt treatment strategies for these patients. Cite this article: Bone Jt Open 2025;6(2):178–185. |
| format | Article |
| id | doaj-art-37f4168cab824ab6bca5ddefefeec134 |
| institution | OA Journals |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-37f4168cab824ab6bca5ddefefeec1342025-08-20T02:02:00ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-02-016217818510.1302/2633-1462.62.BJO-2024-0161.R1Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplastyAlexander Gallant0https://orcid.org/0000-0003-2073-4397Pieter-Jan Vandekerckhove1https://orcid.org/0000-0002-0305-5280Lucas Beckers2https://orcid.org/0000-0002-0307-8941Arne De Smet3https://orcid.org/0000-0002-2859-618XCedric Depuydt4https://orcid.org/0000-0001-8504-5504Jan Victor5https://orcid.org/0000-0003-3988-9014François Hardeman6https://orcid.org/0000-0003-3085-1204Jan Yperman Hospital, Leper, BelgiumUniversiteit Gent (UGent), Gent, BelgiumOrthoclinic Brugge, Brugge, BelgiumVrije Universiteit Brussel (VUB), Ixelles, BelgiumJan Yperman Hospital, Leper, BelgiumUniversiteit Gent (UGent), Gent, BelgiumJan Yperman Hospital, Leper, BelgiumAims: Valgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes. Methods: This prospective multicentre study analyzed 97 knees from 90 patients undergoing UKA across four participating hospitals. A standardized surgical technique was employed uniformly by all participating surgeons. Postoperative evaluations were conducted preoperatively, and one day, four weeks, three months, and one year postoperative, encompassing weightbearing radiographs, bone mineral density assessments, and clinical outcome reports using the Forgotten Joint Score and Oxford Knee Score. Statistical analyses, including non-parametric correlation analysis using the Kendall correlation coefficient and Mann-Whitney U test, were performed to explore associations between subsidence and various patient-related or radiological parameters. Results: A total of eight patients showed more than 2° valgus subsidence (8.2%), higher than previously reported rates. There were significant correlations between subsidence and higher preoperative varus alignment of the tibia, larger adaptation of the preoperative varus to a postoperative neutral or valgus alignment, mediolateral undersizing of the tibial component, excessive lateral load of tibial component by more lateral position of femoral component relative to tibial component, a lower T-score, and female sex. Our study found no significant difference in pain scores between subsidence and non-subsidence groups at various postoperative milestones. Conclusion: These findings corroborate earlier suggested risk factors based on biomechanical models. Further research might provide the opportunity to identify high-risk groups preoperatively and adapt treatment strategies for these patients. Cite this article: Bone Jt Open 2025;6(2):178–185.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0161.R1subsidencevalgus subsidencerisk factorsuncemented medial unicompartmental knee arthroplastymedial unicompartmental knee arthroplastyukavalgustibial componentsfemoral componentskneestibiapain scoresmann-whitney u testradiographsknee arthroplastyt-scores |
| spellingShingle | Alexander Gallant Pieter-Jan Vandekerckhove Lucas Beckers Arne De Smet Cedric Depuydt Jan Victor François Hardeman Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty Bone & Joint Open subsidence valgus subsidence risk factors uncemented medial unicompartmental knee arthroplasty medial unicompartmental knee arthroplasty uka valgus tibial components femoral components knees tibia pain scores mann-whitney u test radiographs knee arthroplasty t-scores |
| title | Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| title_full | Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| title_fullStr | Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| title_full_unstemmed | Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| title_short | Risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| title_sort | risk factors for valgus subsidence in uncemented medial unicompartimental knee arthroplasty |
| topic | subsidence valgus subsidence risk factors uncemented medial unicompartmental knee arthroplasty medial unicompartmental knee arthroplasty uka valgus tibial components femoral components knees tibia pain scores mann-whitney u test radiographs knee arthroplasty t-scores |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.62.BJO-2024-0161.R1 |
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