J Knee Surg 2019; 32(07): 686-700
DOI: 10.1055/s-0038-1666999
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Similar Outcome, but Different Surgical Requirement in Conversion Total Knee Arthroplasty following High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Meta-Analysis

Yong Seuk Lee
1   Department of Orthopedics, Seoul National University Bundang Hospital, Seongnam, Korea
,
Hyun Jung Kim
2   Institute for Evidence-based Medicine and Department of Preventive Medicine, Korea University College of Medicine-Preventive Medicine, Seoul, Korea
,
Su Jung Mok
1   Department of Orthopedics, Seoul National University Bundang Hospital, Seongnam, Korea
,
O-Sung Lee
3   Division of Orthopaedics, Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Gyeonggi-do, Seoul, Korea
› Author Affiliations
Further Information

Publication History

02 September 2017

26 May 2018

Publication Date:
06 August 2018 (online)

Abstract

The present systematic review and meta-analysis were conducted to find out how effective any subsequent conversion total knee arthroplasty (TKA) would be after unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) and which is better in outcomes. A rigorous and systematic approach was used. Each of the selected studies was evaluated for methodological quality. Data were extracted by the following standardized protocol: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, kind of index surgery, type of index surgery, average time to failure, mode of failure, surgical data, preclinical score, post-clinical score, and major related complications. Nineteen articles were included in the final analysis. In conversion TKA following UKA, revision components (metal augment, bone graft, and stem) were frequently used, and thicker polyethylene was used comparing to the primary TKA. In the conversion TKA following HTO, only stem was more common (relative risk of revision component UKA:HTO = 0.57:0.07). The estimated range of motions (ROM) of conversion TKA following HTO and UKA was 107.75° (101.93–113.58°) and 111.84° (108.41–115.26°), respectively (p > 0.05). The knee scores of conversion TKA following HTO and UKA were 89.10 (86.45, 91.75) and 85.48 (79.82, 91.14), respectively (p > 0.05). The function scores were 78.60 (72.44, 84.76) and 75.60 (69.85, 81.35), respectively (p > 0.05). Clinical outcome was similar between conversion TKA following HTO and UKA. However, conversion TKA after UKA required more revision components and thicker polyethylene, while conversion TKA after HTO sometimes required a stem to bypass the osteotomy gap.

 
  • References

  • 1 Matziolis G, Röhner E. [Arthritis of the Medial Knee Joint Compartment]. Z Orthop Unfall 2015; 153 (05) 553-564
  • 2 Mont MA, Stuchin SA, Paley D. , et al. Different surgical options for monocompartmental osteoarthritis of the knee: high tibial osteotomy versus unicompartmental knee arthroplasty versus total knee arthroplasty: indications, techniques, results, and controversies. Instr Course Lect 2004; 53: 265-283
  • 3 Pearse AJ, Hooper GJ, Rothwell AG, Frampton C. Osteotomy and unicompartmental knee arthroplasty converted to total knee arthroplasty: data from the New Zealand Joint Registry. J Arthroplasty 2012; 27 (10) 1827-1831
  • 4 Amendola A, Bonasia DE. Results of high tibial osteotomy: review of the literature. Int Orthop 2010; 34 (02) 155-160
  • 5 W-Dahl A, Robertsson O, Lohmander LS. High tibial osteotomy in Sweden, 1998-2007: a population-based study of the use and rate of revision to knee arthroplasty. Acta Orthop 2012; 83 (03) 244-248
  • 6 Lee DC, Byun SJ. High tibial osteotomy. Knee Surg Relat Res 2012; 24 (02) 61-69
  • 7 Schallberger A, Jacobi M, Wahl P, Maestretti G, Jakob RP. High tibial valgus osteotomy in unicompartmental medial osteoarthritis of the knee: a retrospective follow-up study over 13-21 years. Knee Surg Sports Traumatol Arthrosc 2011; 19 (01) 122-127
  • 8 Bruni D, Gagliardi M, Akkawi I. , et al. Good survivorship of all-polyethylene tibial component UKA at long-term follow-up. Knee Surg Sports Traumatol Arthrosc 2016; 24 (01) 182-187
  • 9 Faour-Martín O, Valverde-García JA, Martín-Ferrero MA. , et al. Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results. Int Orthop 2013; 37 (05) 833-838
  • 10 Mont MA, Sayeed SA, Osuji O. , et al. Total knee arthroplasty in patients 40 years and younger. J Knee Surg 2012; 25 (01) 65-69
  • 11 Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R. High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J 2010; 30: 131-140
  • 12 Rancourt MF, Kemp KA, Plamondon SM, Kim PR, Dervin GF. Unicompartmental knee arthroplasties revised to total knee arthroplasties compared with primary total knee arthroplasties. J Arthroplasty 2012; 27 (8, Suppl): 106-110
  • 13 Murray DW, Liddle AD, Dodd CA, Pandit H. Unicompartmental knee arthroplasty: is the glass half full or half empty?. Bone Joint J 2015; 97-B (10, Suppl A): 3-8
  • 14 Ollivier M, Parratte S, Argenson JN. Results and outcomes of unicompartmental knee arthroplasty. Orthop Clin North Am 2013; 44 (03) 287-300
  • 15 Efe T, Heyse TJ, Boese C. , et al. TKA following high tibial osteotomy versus primary TKA--a matched pair analysis. BMC Musculoskelet Disord 2010; 11: 207
  • 16 Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A. High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 2003; 16 (01) 21-26
  • 17 Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The Install Award. Survivorship of the high tibial valgus osteotomy. A 10- to 22-year followup study. Clin Orthop Relat Res 1999; (367) 18-27
  • 18 Sprenger TR, Doerzbacher JF. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am 2003; 85-A (03) 469-474
  • 19 Han JH, Yang JH, Bhandare NN. , et al. Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy. Knee Surg Sports Traumatol Arthrosc 2016; 24 (08) 2567-2577
  • 20 Börjesson M, Weidenhielm L, Mattsson E, Olsson E. Gait and clinical measurements in patients with knee osteoarthritis after surgery: a prospective 5-year follow-up study. Knee 2005; 12 (02) 121-127
  • 21 Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee 2001; 8 (03) 187-194
  • 22 Cross MB, Yi PY, Moric M, Sporer SM, Berger RA, Della Valle CJ. Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA?. J Arthroplasty 2014; 29 (9, Suppl): 229-231
  • 23 Moher D, Liberati A, Tetzlaff J, Altman DG. ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62 (10) 1006-1012
  • 24 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7 (03) 177-188
  • 25 Sarraf KM, Konan S, Pastides PS, Haddad FS, Oussedik S. Bone loss during revision of unicompartmental to total knee arthroplasty: an analysis of implanted polyethylene thickness from the National Joint Registry data. J Arthroplasty 2013; 28 (09) 1571-1574
  • 26 Akan B, Yıldırım T, Güçlü B, Kaya A, Karagüven D, Cetin I. Outcomes for revision total knee replacement after unicompartmental knee replacement. Acta Orthop Traumatol Turc 2014; 48 (04) 419-423
  • 27 Khan Z, Nawaz SZ, Kahane S, Esler C, Chatterji U. Conversion of unicompartmental knee arthroplasty to total knee arthroplasty: the challenges and need for augments. Acta Orthop Belg 2013; 79 (06) 699-705
  • 28 Oduwole KO, Sayana MK, Onayemi F, McCarthy T, O'Byrne J. Analysis of revision procedures for failed unicondylar knee replacement. Ir J Med Sci 2010; 179 (03) 361-364
  • 29 Robb CA, Matharu GS, Baloch K, Pynsent PB. Revision surgery for failed unicompartmental knee replacement: technical aspects and clinical outcome. Acta Orthop Belg 2013; 79 (03) 312-317
  • 30 Saldanha KA, Keys GW, Svard UC, White SH, Rao C. Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty – results of a multicentre study. Knee 2007; 14 (04) 275-279
  • 31 Sierra RJ, Kassel CA, Wetters NG, Berend KR, Della Valle CJ, Lombardi AV. Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk!. J Arthroplasty 2013; 28 (8, Suppl) 128-132
  • 32 Springer BD, Scott RD, Thornhill TS. Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res 2006; 446 (446) 214-220
  • 33 Amendola L, Fosco M, Cenni E, Tigani D. Knee joint arthroplasty after tibial osteotomy. Int Orthop 2010; 34 (02) 289-295
  • 34 Erak S, Naudie D, MacDonald SJ, McCalden RW, Rorabeck CH, Bourne RB. Total knee arthroplasty following medial opening wedge tibial osteotomy: technical issues early clinical radiological results. Knee 2011; 18 (06) 499-504
  • 35 Haddad FS, Bentley G. Total knee arthroplasty after high tibial osteotomy: a medium-term review. J Arthroplasty 2000; 15 (05) 597-603
  • 36 Kazakos KJ, Chatzipapas C, Verettas D, Galanis V, Xarchas KC, Psillakis I. Mid-term results of total knee arthroplasty after high tibial osteotomy. Arch Orthop Trauma Surg 2008; 128 (02) 167-173
  • 37 Lunebourg A, Parratte S, Ollivier M, Abdel MP, Argenson JN. Are revisions of unicompartmental knee arthroplasties more like a primary or revision TKA?. J Arthroplasty 2015; 30 (11) 1985-1989
  • 38 Meding JB, Wing JT, Ritter MA. Does high tibial osteotomy affect the success or survival of a total knee replacement?. Clin Orthop Relat Res 2011; 469 (07) 1991-1994
  • 39 Preston S, Howard J, Naudie D, Somerville L, McAuley J. Total knee arthroplasty after high tibial osteotomy: no differences between medial and lateral osteotomy approaches. Clin Orthop Relat Res 2014; 472 (01) 105-110
  • 40 Ramappa M, Anand S, Jennings A. Total knee replacement following high tibial osteotomy versus total knee replacement without high tibial osteotomy: a systematic review and meta analysis. Arch Orthop Trauma Surg 2013; 133 (11) 1587-1593
  • 41 Lim JBT, Chong HC, Pang HN. , et al. Revision total knee arthroplasty for failed high tibial osteotomy and unicompartmental knee arthroplasty have similar patient-reported outcome measures in a two-year follow-up study. Bone Joint J 2017; 99-B (10) 1329-1334
  • 42 Bhandari M, Smith J, Miller LE, Block JE. Clinical and economic burden of revision knee arthroplasty. Clin Med Insights Arthritis Musculoskelet Disord 2012; 5: 89-94
  • 43 Robertsson O, W-Dahl A. The risk of revision after TKA is affected by previous HTO or UKA. Clin Orthop Relat Res 2015; 473 (01) 90-93
  • 44 Smith II WB, Steinberg J, Scholtes S, Mcnamara IR. Medial compartment knee osteoarthritis: age-stratified cost-effectiveness of total knee arthroplasty, unicompartmental knee arthroplasty, and high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 2017; 25 (03) 924-933