Abstract
Unicompartmental knee arthroplasty (UKA) has increased in popularity, yet utilization by surgeons varies based on training, experience, or comfort level with the procedure. The operation is growing in popularity, and many institutions are publishing 10-year survival rates above 90%; however, joint replacement registries are still showing relatively high rates of revision and failure compared to total knee arthroplasty (TKA). Among the modes of failure, the frequency of periprosthetic infection following UKA is relatively low and estimated to be between 0.1% and 1.0%. Patients typically present in a similar manner to TKA infections, and surgeons should follow a similar algorithm for appropriate workup and confirmation for infection. Once the diagnosis of UKA infection is confirmed, the best method of management remains unclear, given the limited data available. Options for management include debridement and implant retention (DAIR), one-stage exchange of UKA to TKA and two-stage exchange involving antibiotic spacer placement. The management of UKA PJI involves surgical intervention and involves collaboration with medical and infectious disease services.
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References
Campi S, Tibrewal S, Cuthbert R, Tibrewal SB. Unicompartmental knee replacement – Current perspectives. J Clin Orthop Trauma. 2018;9(1):17–23. https://doi.org/10.1016/j.jcot.2017.11.013.
Mohammad HR, Strickland L, Hamilton TW, Murray DW. Long-term outcomes of over 8,000 medial Oxford Phase 3 Unicompartmental Knees—a systematic review. Acta Orthop. 2018;89(1):101–7. https://doi.org/10.1080/17453674.2017.1367577.
Parratte S, Ollivier M, Lunebourg A, Abdel MP, Argenson J-N. Long-term results of compartmental arthroplasties of the knee. Bone Joint J. 2015;97-B(10_Supple_A):9–15. https://doi.org/10.1302/0301-620X.97B10.36426.
Niinimäki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI. Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee. 2011;18(6):432–5. https://doi.org/10.1016/j.knee.2010.08.004.
Kim KT, Lee S, Lee JI, Kim JW. Analysis and treatment of complications after unicompartmental knee arthroplasty. Knee Surg Relat Res. 2016;28(1):46–54. https://doi.org/10.5792/ksrr.2016.28.1.46.
Bergeson AG, Berend KR, Lombardi AV, Hurst JM, Morris MJ, Sneller MA. Medial mobile bearing unicompartmental knee arthroplasty: early survivorship and analysis of failures in 1000 consecutive cases. J Arthroplast. 2013;28(9 Suppl):172–5. https://doi.org/10.1016/j.arth.2013.01.005.
Foran JRH, Brown NM, Della Valle CJ, Berger RA, Galante JO. Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2013;471(1):102–8. https://doi.org/10.1007/s11999-012-2517-y.
Hernandez NM, Petis SM, Hanssen AD, Sierra RJ, Abdel MP, Pagnano MW. Infection after unicompartmental knee arthroplasty: a high risk of subsequent complications. Clin Orthop Relat Res. 2018;73:1. https://doi.org/10.1097/CORR.0000000000000372.
Labruyère C, Zeller V, Lhotellier L, et al. Chronic infection of unicompartmental knee arthroplasty: One-stage conversion to total knee arthroplasty. Orthop Traumatol Surg Res. 2015;101(5):553–7. https://doi.org/10.1016/j.otsr.2015.04.006.
Vasso M, Corona K, D’Apolito R, Mazzitelli G, Panni A. Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty. Joints. 2017;05(01):044–50. https://doi.org/10.1055/s-0037-1601414.
Epinette J-A, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for Hip and Knee. Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res. 2012;98(6):S124–30. https://doi.org/10.1016/j.otsr.2012.07.002.
Society of Unicondylar Research and Continuing Education. Diagnosis of periprosthetic joint infection after unicompartmental knee arthroplasty. J Arthroplast. 2012;27(8):46–50. https://doi.org/10.1016/j.arth.2012.03.033.
Böhm I, Landsiedl F. Revision surgery after failed unicompartmental knee arthroplasty: a study of 35 cases. J Arthroplast. 2000;15(8):982–9. http://www.ncbi.nlm.nih.gov/pubmed/11112191. Accessed November 17, 2018.
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Bigart, K.C., Nam, D. (2020). Infection Remediation in Unicompartmental Knee Arthroplasty. In: Gerlinger, T. (eds) Unicompartmental Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-27411-5_20
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DOI: https://doi.org/10.1007/978-3-030-27411-5_20
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