Abstract:
BACKGROUND:The literature suggests survivorship of unicompartmental knee arthroplasties (UKAs) for spontaneous osteonecrosis of the knee ranges from 93% to 97% at 10 to 12 years. However, these data arise from small series (23 to 33 patients), jeopardizing meaningful conclusions. QUESTIONS/PURPOSES:We determined (1) the longer-term survivorship of UKAs in a larger group of patients with spontaneous osteonecrosis of the knee; (2) their subjective, symptomatic, and functional outcomes; and (3) the percentage of failures and reasons for failures to identify relevant indications, contraindications, and technical parameters for treatment with a modern implant design. METHODS:We retrospectively evaluated all 84 patients with late-stage spontaneous osteonecrosis of the knee who had a medial UKA from 1998 to 2005. All patients had preoperative MRI to confirm the diagnosis, exclude metaphyseal involvement, and confirm the absence of major degenerative changes in the lateral and patellofemoral compartments. The mean age of the patients at surgery was 66 years and mean BMI was 28.9. We conducted Kaplan-Meier survival analysis using revision for any reason as the end point. Minimum followup was 63 months (mean, 98 months; range, 63-145 months). RESULTS:Ten-year survivorship was 89%. Ten revisions were performed; the most common reasons were subsidence of the tibial component (four) and aseptic loosening of the tibial component (three). No patient underwent revision for progression of osteoarthritis in the lateral or patellofemoral compartments. CONCLUSIONS:Our data suggest spontaneous osteonecrosis of the knee may be an indication for UKA, provided secondary osteonecrosis of the knee is ruled out, preoperative MRI documents the absence of disease in other compartments, and there is no overcorrection in any plane. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Bruni D,Iacono F,Raspugli G,Zaffagnini S,Marcacci Mdoi
10.1007/s11999-012-2246-2subject
Has Abstractpub_date
2012-05-01 00:00:00pages
1442-51issue
5eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract::A retrospective epidemiological study was performed to determine whether postmenopausal osteoporosis is a hereditary condition. Frequency of fractures was calculated in women whose mothers had suffered vertebral fractures after a low-energy trauma three decades earlier. The frequency of fractures was compared to the f...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::Patients who received a single corticosteroid injection for treatment of third webspace plantar interdigital neuroma were studied retrospectively. Forty-three patients (51 feet) were available for followup study (followup mean, 4 years; range, 2 to 6 years). Mean age of patients was 53 years. Pain initially was reliev...
journal_title:Clinical orthopaedics and related research
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abstract::Malignant tumors around fracture fixation implants have been reported sporadically for many years. Recently, however, reports of sarcomatous degeneration around a standard cemented hip arthroplasty and around cobalt-chromium-bearing hip arthroplasties raise new questions of the malignant potential of metallic ends pro...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Soluble factors released from chondrocytes can both enhance and induce chondrocyte-like behavior in cocultured dedifferentiated cells. The ability to similarly prime and modulate biosynthetic activity of differentiated cells encapsulated in a three-dimensional environment is unknown. QUESTIONS/PURPOSES:To u...
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journal_title:Clinical orthopaedics and related research
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abstract::An 11-year-old boy sustained complete brachial artery disruption following closed posterior elbow dislocation. This is the first documentation in the English-language literature of this type of arterial transection following closed elbow dislocation in a child. It is also the first report of surgical repair of the bra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::Seven patients with chronic osteomyelitis were treated by surgical debridement. Cefamandole was administered intravenously before surgery. During the debridement, cefamandole concentrations were measured in serum and necrotic bone. Although adequate levels of antibiotic were achieved in the serum, minimal or no concen...
journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1985-10-01 00:00:00
abstract::Dysplastic acetabula treated with cemented sockets have shown shortcomings due to loosening, bone erosion, and implant migration. A Bateman bipolar prosthesis was used, and the deficient superior acetabular lip was augmented with autologous femoral head graft. The surgical technique "locked" the bipolar cup in the rec...
journal_title:Clinical orthopaedics and related research
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更新日期:1990-02-01 00:00:00
abstract::Two cases of entrapment of suction drainage tubes between the femoral and tibial components were encountered after total knee arthroplasty. The first patient had an arthrotomy because it was believed that the tube was caught in a suture, and while attempting to remove it a portion remained trapped in the joint. At ope...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::Glucocorticoid injection is widely used in tendon disorders. Despite previous studies on the histologic and biomechanical changes in tendons after glucocorticoid injections, the role of glucocorticoid in tendon rupture still is controversial. It was hypothesized that glucocorticoid has a direct deleterious effect on h...
journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
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abstract::Ulnar coronoid process fractures are relatively uncommon injuries usually occurring with elbow dislocations and contributing to elbow instability. Recent evidence suggests coronoid tip fractures have a role in the instability. We sought to quantify the capsular and brachialis attachments of the ulnar coronoid process ...
journal_title:Clinical orthopaedics and related research
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更新日期:2006-08-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1986-06-01 00:00:00
abstract::Transcutaneous electrical neurostimulation relieves chronic and acute pain by blocking the transmission of pain impulses with comfortable electrical stimulation of light touch sensation. The original Gate Control Theory of Melzack and Wall provides a working model to explain the significant pain relief afforded patien...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-01 00:00:00
abstract::Despite their increasing clinical use, mobile-bearing total knee replacements have not been well characterized biomechanically. An experimental and finite element analysis was done to assess the mobility and contact mechanics of a widely used rotating platform total knee replacement. Parameters that varied were axial ...
journal_title:Clinical orthopaedics and related research
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doi:10.1097/00003086-200111000-00004
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journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1987-04-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
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journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
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doi:10.1007/s11999-011-2182-6
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journal_title:Clinical orthopaedics and related research
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doi:10.1097/00003086-200303000-00026
更新日期:2003-03-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:
更新日期:1990-08-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200010000-00026
更新日期:2000-10-01 00:00:00
abstract::The commonly used classification systems of hip dislocation are based on the direction of the dislocation and the presence of associated lesions. However, no rating system can reliably predict the patient's outcome and prognosis based on the initial presentation and classification. In general, patients with anterior d...
journal_title:Clinical orthopaedics and related research
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更新日期:2000-08-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00