Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study.
BACKGROUND
Unicompartmental arthroplasty is a treatment alternative when only one compartment of the knee is affected with arthritis, but the reported results of this procedure have been variable. The purpose of the present study was to evaluate the results of a modern unicompartmental knee arthroplasty performed with use of a cemented metal-backed prosthesis and surgical instrumentation comparable with that used for total knee replacement.


METHODS
The indications for the procedure were osteonecrosis or osteoarthritis associated with full-thickness loss of cartilage that was limited to one tibiofemoral compartment as evaluated on standing and stress radiographs. One hundred and sixty consecutive cemented metal-backed Miller-Galante prostheses in 147 patients were evaluated after a mean duration of follow-up of sixty-six months (range, thirty-six to 112 months). The mean age of the patients at the time of the index procedure was sixty-six years.


RESULTS
Three knees were revised because of progression of osteoarthritis in the patellofemoral joint (two knees) or the lateral tibiofemoral compartment (one knee). Two knees had revision of the polyethylene liner. The average Hospital for Special Surgery knee score improved from 59 points preoperatively to 96 points at the time of the review. According to Kaplan-Meier analysis, the ten-year survival rate (with twenty-nine knees at risk) was 94% +/- 3% with revision for any reason or radiographic loosening as the end point.


CONCLUSIONS
A modern unicompartmental knee arthroplasty is a valid alternative for patients with unicompartmental tibiofemoral noninflammatory disease. The patient selection must be strict with regard to the status of the patellofemoral joint. The preoperative planning includes stress radiographs to assess the correction of the deformity and the status of the uninvolved compartment. Continued long-term follow-up is necessary to evaluate long-term polyethylene wear.
Argenson
Jean-Noël A
JN
Department of Orthopaedic Surgery, the Aix-Marseille University, Hôspital Sainte Marguerite, Marseille, France. jean-noel.argenson@ap_hm.fr
Chevrol-Benkeddache
Yamina
Y
Aubaniac
Jean-Manuel
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010020:Osteonecrosis / Q000601:surgery*; D011474:Prosthesis Design; D012086:Reoperation; D013997:Time Factors
D001843:Bone Cements