Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup.
Sixty-two consecutive cemented modular unicompartmental knee arthroplasties in 51 patients were studied prospectively. At surgery, the other compartments had at most Grade 2 chondromalacia. The average age of the patients at arthroplasty was 68 years (range, 51-84 years). One patient was lost to followup and 10 died with less than 6 years followup. The average followup of the remaining 51 knees was 7.5 years (range, 6-10 years). The preoperative Hospital for Special Surgery knee score of 55 points (range, 30-79 points) improved to 92 points (range, 60-100 points) at followup; 78% (40 knees) had excellent and 20% (10 knees) had good results. The mean range of motion at followup was 120 degrees with 26 knees (51%) having range of motion greater than 120 degrees. One patient underwent revision surgery for retained cement, one patient underwent knee manipulation, and one patient underwent revision surgery at 7 years for opposite compartment degeneration and pain. Radiographically, 26 knees (51%) had at least one partial radiolucency. There were no complete femoral radiolucencies, but there were three complete tibial radiolucencies, all less than 2 mm. No component was loose as seen on radiographs. At final followup, five of the opposite compartments (10%) and three of the patellofemoral joints (6%) had some progressive radiographic joint space loss; this was less than a 25% loss in all but one knee component that was revised. At 6- to 10-years followup, cemented unicompartmental knee arthroplasty yielded excellent clinical and radiographic results. The 10-year survival using radiographic loosening or revision as the end point was 98%. Using stringent selection criteria, unicompartmental knee replacement can yield excellent results and represents a superb alternative to total knee replacement.
Berger
R A
RA
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Nedeff
D D
DD
Barden
R M
RM
Sheinkop
M M
MM
Jacobs
J J
JJ
Rosenberg
A G
AG
Galante
J O
JO
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D016019:Survival Analysis