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J Knee Surg 2013; 26(02): 133-138
DOI: 10.1055/s-0032-1322599
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medial UKA: Favorable Mid-Term Results in Middle-Aged Patients

David Dalury
1   Adult Reconstructive Surgery, Towson Orthopaedic Associates, Towson, Maryland
,
Todd C. Kelley
2   Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio
,
Mary Jo Adams
1   Adult Reconstructive Surgery, Towson Orthopaedic Associates, Towson, Maryland
› Author Affiliations
Further Information

Publication History

01 February 2012

26 May 2012

Publication Date:
30 July 2012 (online)

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Abstract

In middle-aged patients with knee arthritis, surgical treatment options include arthroscopic procedures, osteotomies, and unicompartmental and total knee arthroplasty. Unicompartmental knee osteoarthrosis is particularly challenging and controversial in such patients. From December 2001 through October 2005, we treated 32 consecutive middle-aged patients (46 to 59 years old) with 40 medial unicompartmental knee arthroplasties. Three patients were lost to follow-up, leaving 29 for our study. There were two reoperations: one for loosening at 3 years, and one for disease progression at 5 years. Implant survival was modeled using Kaplan–Meier survival function with observations censored if lost to follow-up. At the 6-year survivorship in this group, the overall implant survival rate was 94.1% (95% CI, 78.3–98.5). Knee Society scores had improved significantly (p < 0.001). There were no other instances of osteolysis or radiographic failure. We concluded that, at mid-term follow-up, unicompartmental knee arthroplasty provided satisfactory results for this challenging population.

Keywords

unicondylar - unicompartmental - middle age - arthroplasty - knee
 

  • References

  • 1 Pagnano MW, Clarke HD, Jacofsky DJ, Amendola A, Repicci JA. Surgical treatment of the middle-aged patient with arthritic knees. Instr Course Lect 2005; 54: 251-259
    PubMedGoogle Scholar
  • 2 Broughton NS, Newman JH, Baily RAJ. Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5-10 years' follow-up. J Bone Joint Surg Br 1986; 68 (3) 447-452
    PubMedGoogle Scholar
  • 3 Insall JN, Joseph DM, Msika C. High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 1984; 66 (7) 1040-1048
    CrossrefPubMedGoogle Scholar
  • 4 Karpman RR, Volz RG. Osteotomy versus unicompartmental prosthetic replacement in the treatment of unicompartmental arthritis of the knee. Orthopedics 1982; 5: 989-991
    PubMedGoogle Scholar
  • 5 Scott RD, Santore RF. Unicondylar unicompartmental replacement for osteoarthritis of the knee. J Bone Joint Surg Am 1981; 63 (4) 536-544
    PubMedGoogle Scholar
  • 6 Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am 2003; 85-A (10) 1968-1973
    PubMedGoogle Scholar
  • 7 Schai PA, Suh JT, Thornhill TS, Scott RD. Unicompartmental knee arthroplasty in middle-aged patients: a 2- to 6-year follow-up evaluation. J Arthroplasty 1998; 13 (4) 365-372
    CrossrefPubMedGoogle Scholar
  • 8 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; 248 (248) 13-14
    PubMedGoogle Scholar
  • 9 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43-B: 752-757
    CrossrefPubMedGoogle Scholar
  • 10 Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 1974; 56 (7) 1391-1396
    CrossrefPubMedGoogle Scholar
  • 11 Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 1989; 248 (248) 9-12
    PubMedGoogle Scholar
  • 12 Moseley JB, O'Malley K, Petersen NJ , et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 2002; 347 (2) 81-88
    Google Scholar
  • 13 Siparsky P, Ryzewicz M, Peterson B, Bartz R. Arthroscopic treatment of osteoarthritis of the knee: are there any evidence-based indications?. Clin Orthop Relat Res 2007; 455: 107-112
    CrossrefPubMedGoogle Scholar
  • 14 Weale AE, Newman JH. Unicompartmental arthroplasty and high tibial osteotomy for osteoarthrosis of the knee. A comparative study with a 12- to 17-year follow-up period. Clin Orthop Relat Res 1994; 302 (302) 134-137
    PubMedGoogle Scholar
  • 15 Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am 1989; 71 (1) 145-150
    PubMedGoogle Scholar
  • 16 Insall J, Walker P. Unicondylar knee replacement. Clin Orthop Relat Res 1976; 120 (120) 83-85
    PubMedGoogle Scholar
  • 17 Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am 1978; 60 (2) 182-185
    PubMedGoogle Scholar
  • 18 Berger RA, Meneghini RM, Jacobs JJ , et al. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 2005; 87 (5) 999-1006
    CrossrefPubMedGoogle Scholar
  • 19 Berger RA, Nedeff DD, Barden RM , et al. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res 1999; 367 (367) 50-60
    PubMedGoogle Scholar
  • 20 Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 1996; 11 (7) 782-788
    CrossrefPubMedGoogle Scholar
  • 21 Heck DA, Marmor L, Gibson A, Rougraff BT. Unicompartmental knee arthroplasty. A multicenter investigation with long-term follow-up evaluation. Clin Orthop Relat Res 1993; 286 (286) 154-159
    PubMedGoogle Scholar
  • 22 Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998; 80 (6) 983-989
    CrossrefPubMedGoogle Scholar
  • 23 Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC. Unicompartmental knee replacement. A minimum 15.  year followup study. Clin Orthop Relat Res 1999; 367 (367) 61-72
    PubMedGoogle Scholar
  • 24 Svärd UCG, Price AJ. Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br 2001; 83 (2) 191-194
    CrossrefPubMedGoogle Scholar
  • 25 Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med 2009; 37 (10) 2053-2063
    CrossrefPubMedGoogle Scholar
  • 26 Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H. Proximal tibial osteotomy. Factors that influence the duration of satisfactory function. Clin Orthop Relat Res 1988; 229 (229) 193-200
    PubMedGoogle Scholar
  • 27 Rudan JF, Simurda MA. High tibial osteotomy. A prospective clinical and roentgenographic review. Clin Orthop Relat Res 1990; 255 (255) 251-256
    PubMedGoogle Scholar
  • 28 Yasuda K, Majima T, Tsuchida T, Kaneda K. A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 1992; 282 (282) 186-195
    PubMedGoogle Scholar
  • 29 Closkey RF, Windsor RE. Alterations in the patella after a high tibial or distal femoral osteotomy. Clin Orthop Relat Res 2001; (389) 51-56
    PubMedGoogle Scholar
  • 30 Whitehead TS, Willits K, Bryant D, Giffin JR, Fowler PJ. Impact of medial opening or lateral closing tibial osteotomy on bone resection and posterior cruciate ligament integrity during knee arthroplasty. J Arthroplasty 2009; 24 (6) 979-989
    CrossrefPubMedGoogle Scholar
  • 31 McAuley JP, Engh GA, Ammeen DJ. Revision of failed unicompartmental knee arthroplasty. Clin Orthop Relat Res 2001; 392 (392) 279-282
    CrossrefPubMedGoogle Scholar
  • 32 Padgett DE, Stern SH, Insall JN. Revision total knee arthroplasty for failed unicompartmental replacement. J Bone Joint Surg Am 1991; 73 (2) 186-190
    PubMedGoogle Scholar
  • 33 Cartier P, Khefacha A, Sanouiller JL, Frederick K. Unicondylar knee arthroplasty in middle-aged patients: a minimum 5-year follow-up. Orthopedics 2007; 30 (8, Suppl) 62-65
    PubMedGoogle Scholar
  • 34 Parratte S, Argenson JN, Pearce O, Pauly V, Auquier P, Aubaniac JM. Medial unicompartmental knee replacement in the under-50s. J Bone Joint Surg Br 2009; 91 (3) 351-356
    CrossrefPubMedGoogle Scholar