Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty
ESSKA Academy. Schiavone Panni A. 11/08/19; 284360; epEKA-13
Prof. Alfredo Schiavone Panni
Prof. Alfredo Schiavone Panni
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Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty

ePoster - epEKA-13

Topic: UKA

Vasso M., Schiavone Panni A.
University of Naples, Multidisciplinary Department of Medico-Surgical and Dentistry Specialties, Naples, Italy

Introduction: Despite the excellent success rates of the modern UKA, results of knee replacement registries still show a relatively high revision and failure rate for UKA, especially when compared to traditional TKA. On the other hand, when the revision is required most of failed UKAs are converted to TKAs.
Objectives and Aims: The purpose of this study was therefore to elucidate the main causes and mechanisms of UKA failure, the principal surgical notes and steps that could be needed during the conversion to TKA, and the main outcomes of the UKAs revised by a TKA.
Methods: The recent Literature was read and analyzed to clarify the most frequent causes of failure of the modern UKAs (both mobile and fixed), and the principal skills to revise those to a TKA.
Results: Bearing dislocation continues to be advocated as the predominant mechanism of failure in mobile UKA, whereas polyethylene wear and aseptic loosening remains the main cause of fixed UKA. Degeneration of the un-replaced compartments has been reported both in mobile and fixed designs. Infection is really rare, especially when compared to TKA. Regardless the implant design, most of the failures occur in medial UKA when compared to lateral UKA. Conversion to TKA may result technically demanding, especially in septic revisions. Preoperative planning is mandatory to anticipate the need for revision components (metal augments and stems) as well as the availability of constrained implants. Most of the Authors confirm how the conversion of UKA to TKA is technically more demanding when compared to a primary TKA, with final results often inferior to a primary TKA.
Conclusion: Incidence of failure is greatly diminished in the last generation UKA, whereas bearing dislocation, polyethylene wear, mechanical loosening and progression of osteoarthritis continue to affect the final survivorship of contemporary UKA. Converting a UKA to a TKA is more complicated than performing a primary TKA, and clinical and functional results after revision TKA for a failed UKA could be inferior to those of a primary TKA. A primary implant (generally PS) can usually be used to convert a failed UKA to a TKA; however, surgeons should be aware that when converting a UKA to TKA stems and augments on the tibial side are often required.
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