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Hinge prostheses in the revision of unicompartmental knee replacement : a descriptive analysis of data from the national joint registry for England, Wales and Northern Ireland
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Appleyard, Tom, Avery, Peter, Baker, Paul, Clement, Nick D., Mason, James and Deehan, David J. (2024) Hinge prostheses in the revision of unicompartmental knee replacement : a descriptive analysis of data from the national joint registry for England, Wales and Northern Ireland. Archives of Orthopaedic and Trauma Surgery, 144 . pp. 23-30. doi:10.1007/s00402-023-05010-w ISSN 0936-8051.
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Official URL: https://doi.org/10.1007/s00402-023-05010-w
Abstract
Introduction
Unicompartmental knee replacement (UKR) is an effective surgical strategy in patients with isolated medial or lateral compartment osteoarthritis. Study aims were to (1) describe the epidemiology of patients undergoing revision of UKR to a hinge knee replacement (HKR); (2) identify factors influencing time to revision; (3) evaluate HKR survival.
Materials and methods
An analysis of National Joint Registry data was undertaken, exploring revision of UKR to HKR between 2007 and April 2021. Descriptive analysis of eligible patients and Cox Regression to identify key determinants of time to revision were performed. Failure of HKR post-revision was assessed using survival analysis.
Results
111 patients underwent revision of UKR to HKR. Median age at revision was 70 years and most common indications were instability (n = 42) and infection (n = 22). The most common implant was a rotating HKR. Significant independent factors associated with earlier revision were periprosthetic fracture (p = 0.03) and malalignment (p = 0.03). Progressive osteoarthritis (p = 0.01) and higher ASA grades (3: p = 0.01, 4: p < 0.01) delayed time to revision; patient sex and age were not significant factors. Ten patients required subsequent re-revision; median age at re-revision was 61 years. HKR revised from UKR had an 89.3% revision-free risk at 5 years. Male sex (p < 0.01) and younger age (p < 0.01) were associated with re-revision.
Conclusions
Factors associated with time to revision may be used to counsel patients prior to UKR. The survivorship of the HKR of 89.3% at 5 years is concerning and careful consideration should be given when using this level of constraint when revising UKR in younger or male patients.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RD Surgery | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
SWORD Depositor: | Library Publications Router | ||||||||
Library of Congress Subject Headings (LCSH): | Arthroplasty, Knee -- Surgery, Artificial knee, Total knee replacement -- Reoperation, Reoperation | ||||||||
Journal or Publication Title: | Archives of Orthopaedic and Trauma Surgery | ||||||||
Publisher: | Springer | ||||||||
ISSN: | 0936-8051 | ||||||||
Official Date: | January 2024 | ||||||||
Dates: |
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Volume: | 144 | ||||||||
Page Range: | pp. 23-30 | ||||||||
DOI: | 10.1007/s00402-023-05010-w | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Re-use Statement: | “This version of the article has been accepted for publication, after peer review (when applicable) but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00402-023-05010-w. Use of this Accepted Version is subject to the publisher’s Accepted Manuscript terms of use https://www.springernature.com/gp/open-research/policies/acceptedmanuscript-terms”." | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 10 November 2023 |
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