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Revision total knee arthroplasty for failed unicompartmental replacement.
D E Padgett1, S H Stern, J N Insall
1Knee Service, Hospital for Special Surgery, New York, N.Y. 10021.
The Journal of Bone and Joint Surgery. American Volume
|February 1, 1991
Summary
Revision total knee arthroplasty after failed unicompartmental knee replacement can be technically demanding. This study found significant osseous defects and radiolucent lines, challenging the notion of a conservative approach.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Unicompartmental knee replacement (UKR) is a less invasive alternative to total knee replacement (TKR).
- The long-term outcomes and technical implications of revision TKR following failed UKR are not fully elucidated.
Purpose of the Study:
- To evaluate the outcomes of revision total knee arthroplasty (TKR) after failed unicompartmental knee replacement (UKR).
- To assess the technical challenges and radiographic findings associated with these revision procedures.
Main Methods:
- Retrospective evaluation of 19 patients (21 knees) who underwent revision TKR after prior UKR.
- Analysis of clinical outcomes (excellent, good, fair, poor), interval between surgeries, intraoperative findings (osseous defects), and radiographic results (radiolucent lines) at follow-up.
Main Results:
- Twelve excellent, four good, one fair, and two poor clinical outcomes were reported.
- Major osseous defects were present in 76% of knees at revision.
- Radiolucent lines were observed in 62% of knees at follow-up, with a 2-10 year observation period.
Conclusions:
- Revision TKR after failed UKR presents significant technical challenges.
- UKR should not be considered a conservative procedure that simplifies future TKR.
- Revision TKR following UKR failure is technically demanding, comparable to revisions after failed primary TKR.