Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre
Abstract Purpose Medial unicompartmental knee arthroplasty (UKA) is a treatment option for medial knee osteoarthritis, with an increase in surgeries over the last few years. However, the results of revision total knee arthroplasty (TKA) after a UKA vary greatly. The purpose of the study was to exami...
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Wiley
2025-04-01
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| Series: | Journal of Experimental Orthopaedics |
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| Online Access: | https://doi.org/10.1002/jeo2.70250 |
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| author | Sebastian Bockholt Georg Gosheger Burkhard Moellenbeck Kristian Nikolaus Schneider Jan Schwarze Christoph Theil |
| author_facet | Sebastian Bockholt Georg Gosheger Burkhard Moellenbeck Kristian Nikolaus Schneider Jan Schwarze Christoph Theil |
| author_sort | Sebastian Bockholt |
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| description | Abstract Purpose Medial unicompartmental knee arthroplasty (UKA) is a treatment option for medial knee osteoarthritis, with an increase in surgeries over the last few years. However, the results of revision total knee arthroplasty (TKA) after a UKA vary greatly. The purpose of the study was to examine the survival after revision TKA of a failed UKA. Methods This is a retrospective single‐centre analysis that includes 35 revision TKA procedures after the failed UKA performed from 2004 to 2019. The median follow‐up after revision TKA was 39 months (interquartile range [IQR]: 32–52). The indication for revision of the UKA was aseptic loosening in 49% of patients (17/35). We evaluated demographic factors, reason for revision and revision implant used with descriptive statistics. Implant survival analysis with a focus on re‐revision‐free survival and potential re‐revisions was performed using Kaplan–Meier survival curves. Differences in survival were analyzed using the log‐rank test. p Value was set at 0.05. Results Forty per cent (14/35) of revision implants were posterior stabilized revision TKA, followed by 34% (12/35) of condylar constrained designs and 23% of rotating hinged TKA (8/35). Only one patient was revised to a cruciate retaining primary implant (3%). The re‐revision‐free survival after revision TKA amounted to 94% (95% confidence interval [CI]: 91%–100%) after 1 year, 80% (95% CI: 67%–93%) after 2 years and 74% (95% CI: 56%–90%) at 5 years. Twenty‐three per cent of patients (8/35) underwent re‐revision after the initial UKA revision after a median time period of 21 months (IQR: 12–24). The reasons for repeat revision were tibial aseptic loosening in 9% of patients (3/35), periprosthetic joint infection (PJI) in 9% of patients (3/35) and instability in 5% (2/35). Rotating hinge knee implants showed reduced survivorship. Conclusions Revision of medial UKA is associated with an increased use of more elaborate and complex revision implants. There is a substantial risk of repeat revision, with aseptic tibial loosening and PJI being the main reasons for the failure of this series. Level of Evidence Level III. |
| format | Article |
| id | doaj-art-7799cd74c97f44129c631c5bf2b7a33e |
| institution | Kabale University |
| issn | 2197-1153 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
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| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-7799cd74c97f44129c631c5bf2b7a33e2025-08-20T03:44:05ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70250Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centreSebastian Bockholt0Georg Gosheger1Burkhard Moellenbeck2Kristian Nikolaus Schneider3Jan Schwarze4Christoph Theil5Department of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyDepartment of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyDepartment of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyDepartment of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyDepartment of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyDepartment of Orthopedics and Tumor Orthopedics Muenster University Hospital Muenster GermanyAbstract Purpose Medial unicompartmental knee arthroplasty (UKA) is a treatment option for medial knee osteoarthritis, with an increase in surgeries over the last few years. However, the results of revision total knee arthroplasty (TKA) after a UKA vary greatly. The purpose of the study was to examine the survival after revision TKA of a failed UKA. Methods This is a retrospective single‐centre analysis that includes 35 revision TKA procedures after the failed UKA performed from 2004 to 2019. The median follow‐up after revision TKA was 39 months (interquartile range [IQR]: 32–52). The indication for revision of the UKA was aseptic loosening in 49% of patients (17/35). We evaluated demographic factors, reason for revision and revision implant used with descriptive statistics. Implant survival analysis with a focus on re‐revision‐free survival and potential re‐revisions was performed using Kaplan–Meier survival curves. Differences in survival were analyzed using the log‐rank test. p Value was set at 0.05. Results Forty per cent (14/35) of revision implants were posterior stabilized revision TKA, followed by 34% (12/35) of condylar constrained designs and 23% of rotating hinged TKA (8/35). Only one patient was revised to a cruciate retaining primary implant (3%). The re‐revision‐free survival after revision TKA amounted to 94% (95% confidence interval [CI]: 91%–100%) after 1 year, 80% (95% CI: 67%–93%) after 2 years and 74% (95% CI: 56%–90%) at 5 years. Twenty‐three per cent of patients (8/35) underwent re‐revision after the initial UKA revision after a median time period of 21 months (IQR: 12–24). The reasons for repeat revision were tibial aseptic loosening in 9% of patients (3/35), periprosthetic joint infection (PJI) in 9% of patients (3/35) and instability in 5% (2/35). Rotating hinge knee implants showed reduced survivorship. Conclusions Revision of medial UKA is associated with an increased use of more elaborate and complex revision implants. There is a substantial risk of repeat revision, with aseptic tibial loosening and PJI being the main reasons for the failure of this series. Level of Evidence Level III.https://doi.org/10.1002/jeo2.70250revision TKATKAtotal knee arthroplastyUKAunicompartmental knee arthroplasty |
| spellingShingle | Sebastian Bockholt Georg Gosheger Burkhard Moellenbeck Kristian Nikolaus Schneider Jan Schwarze Christoph Theil Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre Journal of Experimental Orthopaedics revision TKA TKA total knee arthroplasty UKA unicompartmental knee arthroplasty |
| title | Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre |
| title_full | Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre |
| title_fullStr | Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre |
| title_full_unstemmed | Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre |
| title_short | Revision of medial unicompartmental knee arthroplasty—Not as uncomplicated as one thought? Analysis of survival and re‐revisions from a single centre |
| title_sort | revision of medial unicompartmental knee arthroplasty not as uncomplicated as one thought analysis of survival and re revisions from a single centre |
| topic | revision TKA TKA total knee arthroplasty UKA unicompartmental knee arthroplasty |
| url | https://doi.org/10.1002/jeo2.70250 |
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