Survival of bicompartmental knee arthroplasty at 5 to 23 years.
Recent literature suggests patients achieve substantial short-term functional improvement after combined bicompartmental implants but longer-term durability has not been documented. We therefore asked whether (1) bicompartmental arthroplasty (either combined medial unicompartmental knee arthroplasty (UKA) and femoropatellar arthroplasty (PFA) or medial UKA/PFA, or combined medial and lateral UKA or bicompartmental UKA) reliably improved Knee Society pain and function scores; (2) bicompartmental arthroplasty was durable (survivorship, radiographic loosening, or symptomatic disease progression); (3) we could achieve durable alignment; and (4) the arthritis would progress in the unresurfaced compartment. We retrospectively reviewed 84 patients (100 knees) with bicompartmental UKA and 71 patients (77 knees) with medial UKA/PFA. Clinical and radiographic evaluations were performed at a minimum followup of 5 years (mean, 12 years; range, 5-23 years). Bicompartmental arthroplasty reliably alleviated pain and improved function. Prosthesis survivorship at 17 years was 78% in the bicompartmental UKA group and 54% in the medial UKA/PFA group. The high revision rate, compared with total knee arthroplasty, may be related to several factors such as implant design, patient selection, crude or absent instrumentation, or component malalignment, which can all contribute to the relatively high failure rate in this series.


METHODS
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Parratte
Sebastien
S
Service de Chirurgie Orthopediquem, Center for Arthritis Surgery, Aix-Marseille University, Hôpital Sainte Marguerite, 270, Boulevard Sainte-Marguerite, 13009 Marseille, France.
Pauly
Vanessa
V
Aubaniac
Jean-Manuel
JM
Argenson
Jean-Noel A
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation / Q000601:surgery; D010146:Pain / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome