{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:42:45Z","timestamp":1785444165640,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Disease progression in the untreated compartment is the leading cause for reoperation following unicompartmental knee arthroplasty (UKA). A less\u2010invasive alternative to total knee arthroplasty (TKA) conversion is the addition of a second UKA. The study assessed survival, functional, and radiological outcomes after two\u2010staged bicompartmental UKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was performed on 102 knees (98 patients, mean age 73.7 years) who received an additional medial (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) or lateral UKA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200973) between 2016 and 2025 with a minimum follow\u2010up of 1 year. Primary outcomes were cumulative revision rates for (1) any reoperation and (2) implant revision. Functional outcomes included the Oxford Knee Score (OKS) and UCLA (University of California, Los Angeles) Activity Score. Radiographic assessment included measurement of the hip\u2010knee\u2010ankle angle (HKAA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean follow\u2010up was 4.0 years (SD 2.1). At 9 years, cumulative survival rate was 84.3% (95% CI: 0.763\u20130.923) for any reoperation and 89.3% (95% CI: 0.822\u20130.964) for implant revision. There were nine implant revisions (8.8%), most commonly due to medial mobile\u2010bearing dislocation (44.4%). In 50%, implant revision to TKA was performed using primary non\u2010modular components. Mean postoperative OKS and UCLA scores were 40.4 (SD 8.0) and 5.5 (SD 1.7), respectively. Medial osteonecrosis (ON) following primary lateral UKA accounted for 38% (11\/29) of all indications for an additional medial UKA, and was associated with greater HKAA correction following prior lateral UKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Two\u2010staged bicompartmental UKA is a viable less\u2010invasive alternative to TKA conversion for patients with disease progression or ON after primary UKA. This approach demonstrates excellent mid\u2010term functional outcomes and satisfactory implant survivorship, providing valuable evidence to support its role as a contemporary revision option Fixed\u2010bearing implants for additional medial UKA are advised to eliminate the risk of bearing dislocations. In the absence of major complications, conversion to non\u2010modular TKA components is feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70040","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T11:49:44Z","timestamp":1758023384000},"page":"1336-1345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Excellent functional outcome and satisfactory revision rates of two\u2010staged bicompartmental knee arthroplasty for disease progression following unicompartmental knee arthroplasty"],"prefix":"10.1002","volume":"34","author":[{"given":"Conradin","family":"Schweizer","sequence":"first","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzel","family":"Waldstein","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"},{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"R\u00fchle","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Urban","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Krug","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Herre","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Aldinger","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-4316","authenticated-orcid":false,"given":"Christian","family":"Merle","sequence":"additional","affiliation":[{"name":"Orthopaedic Clinic Paulinenhilfe Diakonie\u2010Klinikum Hospital Stuttgart 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