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J Knee Surg
DOI: 10.1055/s-0044-1785222
Original Article

Difference in the Extension Gap Between Osteoarthritis and Osteonecrosis in Medial Fixed-Bearing Unicompartmental Knee Arthroplasty with the Spacer Block Technique

Naoki Nakano MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Toshihisa Maeda MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Yuichi Kuroda MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Kazunari Ishida MD
2   Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Nada-ku, Kobe, Hyogo, Japan
,
Shinya Hayashi MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Yuichi Hoshino MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Takehiko Matsushita MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Ryosuke Kuroda MD
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
,
Tomoyuki Matsumoto MD 
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
› Author Affiliations Funding This work was supported by Takeda Science Foundation.
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Abstract

The spacer block technique is widely used in medial fixed-bearing unicompartmental knee arthroplasty (UKA) for osteoarthritis (OA) and osteonecrosis (ON), while it is still unclear if there is any difference in the extension gap between UKAs for the two conditions. To clarify the question, the data from 87 consecutive patients (OA: 57 patients and ON: 30 patients) who underwent medial fixed-bearing UKA with the spacer block technique were retrospectively collected and analyzed. The component gap between the medial tibial osteotomy surface and the femoral trial prosthesis in extension was measured using a UKA tensor, and the preosteotomy gap was calculated in each condition. Also, pre- and postoperative coronal hip–knee–ankle (HKA) angles, the thickness of the insert, and the amount of distal femoral and proximal tibial osteotomy were measured and compared between the two groups. As a result, the mean preosteotomy gap in Group OA and Group ON was 5.4 and 3.7 mm, respectively (p < 0.001). The amount of change in HKA angle following UKA in Group OA and Group ON was 4.4and 3.8 degrees, respectively (p = 0.044), while no significant difference was found regarding pre- and postoperative HKA angle between them. Also, thinner inserts tended to be used in Group ON than in Group OA, while no significant difference in the amount of osteotomies was found between them. Since knees with OA and ON showed different biomechanical conditions at medial fixed-bearing UKA probably for the difference in the amount of remaining cartilage, the surgical technique should be carefully considered for each condition.

Keywords

unicompartmental knee arthroplasty - osteonecrosis - osteoarthritis - soft tissue release - spacer block technique

Ethical Approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Consent to Participate

Written informed consent was obtained from all patients.


Consent to Publish

Written informed consent was obtained from all patients.


Competing Interests

The authors declare that they have no competing interests.


Availability of Data and Materials

The authors can confirm that all relevant data are included in the article.




Publication History

Received: 16 March 2023

Accepted: 01 March 2024

Article published online:
29 March 2024

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