Impact of Proximal Tibial Varus Anatomy on Survivorship After Medial Unicondylar Knee Arthroplasty |
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| Institution: | 1. Joint Implant Surgeons, Inc, New Albany, Ohio;2. Mount Carmel Health System, New Albany, Ohio;1. Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana;2. LSUHSC Department of Orthopedic Surgery, New Orleans, Louisiana;3. Ochsner Sports Medicine Institute, Jefferson, Louisiana;1. Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia;2. Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia;3. Fundación Valle del Lili, Departamento de Ortopedia y Traumatología, Cali, Colombia;1. AOANJRR (Australian Orthopaedic Association National Joint Replacement Registry), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia;2. Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia;3. School of Clinical Medicine, UNSW Medicine and Health, Liverpool, Australia;4. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia;5. ANZDATA (Australia and New Zealand Dialysis and Transplant Registry), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia;6. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia;1. Dignity Health Medical Group, Arizona Creighton University School of Medicine- Phoenix, Phoenix, Arizona;2. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan;3. Northwell Health Orthopaedic Institute at Lenox Hill, New York, New York;4. Department of Orthopedic Surgery, St. Joseph Mercy Hospital, Ann Arbor, Michigan;1. Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia;2. Johns Hopkins Department of Orthopaedic Surgery, Columbia, Maryland;3. Department of Orthopaedic Surgery, Penn Orthopaedics, Philadelphia, Pennsylvania;4. Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri;5. Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia |
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| Abstract: | BackgroundPrecise indications for medial unicondylar knee arthroplasty (UKA) continue to be defined. It is unclear if patients who have proximal tibia vara should be considered candidates for UKA. The purpose of this study was to evaluate the impact of proximal tibial varus alignment on outcomes after UKA.MethodsA retrospective review identified 2,416 patients (3,029 knees) who underwent mobile-bearing medial UKA with 2-year minimum follow-up or revision. Preoperative radiographs were evaluated, and medial proximal tibial angle (mPTA) was measured. Patients were grouped into two groups as follows: mPTA <80 degrees and mPTA ≥80 degrees. Analyses were performed on the impact of mPTA on clinical outcomes, all-cause revisions, and tibial failures.ResultsAt a mean follow-up of 5 years (range, 0.5 years to 12.8 years), there was not a statistically significant difference in clinical outcomes nor increased risk for all-cause revision or tibial failure in patients who had an mPTA <80°. Mean mPTA in patients who had tibial failures was 82.5° and not significantly different than those who did not have a tibial failure (82.9°) (P = .289). Tibial failure rate in knees with an mPTA <80° was 2.2% and not significantly different than knees with an mPTA ≥80° at 1.4% (P = .211). The all-cause revision rate in knees with an mPTA <80° was 5.8% and was not significantly different than knees with an mPTA ≥80° at 4.9% (P = .492).ConclusionPatients who have tibia vara are not at increased risk for tibial related or all-cause failure in medial UKA. This data may allow surgeons to increase their indications for medial UKA. |
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| Keywords: | unicompartmental knee arthroplasty indications tibia vara survivorship alignment medial |
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