ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Total and unicondylar knee arthroplasty are equivalent treatment options in end-stage spontaneous osteonecrosis of the knee, and the size of the lesion has no influence on the results.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- A systematic review and meta-analysis comparing outcomes following total knee arthroplasty for rheumatoid arthritis versus for osteoarthritis.BMC musculoskeletal disorders · 2023Pooled it
- Knee arthroplasty for spontaneous osteonecrosis of the knee: a matched analysis comparing total and unicompartmental.Musculoskeletal surgery · 2026Article
- Subchondral insufficiency fracture of the knee.Orthopadie (Heidelberg, Germany) · 2025Review
- Obstructive sleep Apnoea in patients with knee osteoarthritis before total knee arthroplasty and its impact on post-operative recovery of blood oxygen concentrations.Archives of orthopaedic and trauma surgery · 2025Observational
- Subchondral insufficiency fracture of the knee: progress in the pathogenesis and treatment.Frontiers in surgery · 2025Review
- Unicompartmental Knee Arthroplasty Versus Opening-Wedge High Tibial Osteotomy for Spontaneous Osteonecrosis of the Knee: A Retrospective Cohort Study.Orthopaedic journal of sports medicine · 2024Article
- Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights.Biomedicines · 2024Review
- Osteonecrosis of the Knee: The Unintended Consequence of Steroid Abuse.Clinical medicine & research · 2024Article
- Functional improvement of unicompartmental knee arthroplasty compared with total knee arthroplasty for subchondral insufficiency fracture of the knee.Scientific reports · 2023Article
- The impact of preoperative MRI-detected lateral meniscal intra-substance signal abnormalities on mid-term functional outcomes following mobile-bearing unicompartmental knee arthroplasty.International orthopaedics · 2023Article
- How to Perform Better on Oxford UKA? A Technical Note from over 500 Surgical Experiences.Orthopaedic surgery · 2023Article
- Changes in epidemiological characteristics of knee arthroplasty in eastern, northern and central China between 2011 and 2020.Journal of orthopaedic surgery and research · 2023Article
- Unicompartmental knee arthroplasty (UKA) for primary spontaneous osteonecrosis of the knee (SONK): a systematic review.Orthopedic reviews · 2023Article
- A Case of Subchondral Insufficiency Fracture of the Knee at Lateral Femoral Condyle Treated With Unicompartmental Knee Arthroplasty.Arthroplasty today · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the present study was to compare total (TKA) and unicondylar (UKA) knee arthroplasty for spontaneous osteonecrosis of the knee (SONK), and to investigate potential correlations to radiographic parameters.
methodsAll consecutive patients with a magnetic resonance imaging (MRI) proven SONK treated with either TKA or UKA between 2002 and 2018 were analysed. The primary outcomes were postoperative complications and failure rates. Functional assessment included Knee Society Score (KSS), WOMAC Score, and range of motion. A novel three-dimensional measurement method was established to determine the size of the osteonecrotic lesion. All outcome parameters were correlated to the size of the necrotic lesion using Spearman's rank correlation.
resultsThe two treatment groups (34 TKAs, 37 UKAs) did not differ regarding age, body mass index, and ratio of the volume of the necrotic lesion to the volume of the femoral condyle (n.s.). At a mean follow-up of 6.6 years, patients with UKA had better functional outcomes compared to patients with a TKA (WOMAC Score 1.0 vs. 1.6, p = 0.04; KSS pain 86 vs. 83, n.s), with a similar complication rate. No correlation was found between necrotic lesion size and failure rate (n.s.).
conclusionUKA is a valuable treatment option for SONK leading to good functional results and a low failure rate. In case of a surgeon's concern regarding implant anchorage, TKA represents an equivalent solution. The MR-tomographic size of the osteonecrotic lesions seems to have no influence on the results. LEVEL OF EVIDENCE: III.
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