Evidence map›Paper›PMID 40223677›Full record

ArticleActa orthopaedica2025

Survival rate and use of revision components in total knee arthroplasty following unicompartmental knee arthroplasty or proximal tibial osteotomy: an analysis of 11,983 procedures from the Dutch Arthroplasty Register.

Maarten R Huizinga, Astrid J De Vries, Liza N Van Steenbergen, Reinoud W Brouwer

Abstract read
In one paragraph

Article in Acta orthopaedica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Selecting between UKA and HTO in the grey zone.Journal of orthopaedic translation · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Maarten R HuizingaDepartment of Orthopedic Surgery, Martini Hospital, Groningen, the Netherlands. m.r.huizinga@mzh.nl.ORCID 0000-0002-3357-6650
Astrid J De VriesDepartment of Orthopedic Surgery, Martini Hospital, Groningen, the Netherlands.
Liza N Van SteenbergenDutch Arthroplasty Register (LROI), 's-Hertogenbosch, the Netherlands.ORCID 0000-0002-8141-842X
Reinoud W BrouwerDepartment of Orthopedic Surgery, Martini Hospital, Groningen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeUnicompartmental osteoarthritis of the knee can be treated with high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA). This study aimed to investigate the use of revision components in total knee arthroplasty (TKA) after HTO or UKA and to investigate the revision-free survival of the 2 groups of TKA at different time points, including reasons for revision.

methodsTKAs after HTO and revision TKAs after failed UKA in the years 2007-2022 were selected from the Dutch Arthroplasty Register. For complexity, the usage of revision components was analyzed. Kaplan-Meier survival analysis was used to estimate survival rate. Multivariable Cox proportional hazards regression analyses were used to estimate the risk of revision, considering potential confounders. Indications of revision were evaluated.

results11,983 procedures were analyzed (9,835 HTO-TKA and 2,148 UKA-TKA). In the HTO-TKA group, 3% had revision components in the TKA compared with 22% in the UKA-TKA group (P < 0.001). After 12 years' follow-up the revision-free survival was 90.4% (95% confidence interval [CI] 89.6-91.2) for HTO-TKA and 81.7% (CI 79.3-84.1) for UKA-TKA. The multivariable Cox regression analysis showed that UKA-TKA was a significant risk factor for a revision of the TKA (hazard ratio 2.3, CI 1.8-2.6), compared with HTO-TKA. In both groups the most frequent reason for revision was instability, followed by patellar pain and loosening of the tibial component.

conclusionTKAs after UKAs had higher use of revision components and a lower survival rate compared with TKAs following an HTO. The choice of surgical treatment should be considered for the young and active patient with unicompartmental knee osteoarthritis.

Indexed as

Arthroplasty, Replacement, KneeOsteoarthritis, KneeOsteotomyReoperationTibiaAgedFemaleHumansKnee ProsthesisMaleMiddle AgedNetherlandsProsthesis FailureRegistries

Identifiers

PMID40223677
PMCPMC11995432

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