Author(s): Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ,
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Abstract BACKGROUND: There is a renewed interest in unicompartmental knee arthroplasty. The present report describes the minimum ten-year results associated with a unicompartmental knee arthroplasty design that is in current use. METHODS: Sixty-two consecutive unicompartmental knee arthroplasties that were performed with cemented modular Miller-Galante implants in fifty-one patients were studied prospectively both clinically and radiographically. All patients had isolated unicompartmental disease without patellofemoral symptoms. No patient was lost to follow-up. Thirteen patients (thirteen knees) died after less than ten years of follow-up, leaving thirty-eight patients (forty-nine knees) with a minimum of ten years of follow-up. The average duration of follow-up was twelve years. RESULTS: The mean Hospital for Special Surgery knee score improved from 55 points preoperatively to 92 points at the time of the final follow-up. Thirty-nine knees (80\%) had an excellent result, six (12\%) had a good result, and four (8\%) had a fair result. At the time of the final follow-up, thirty-nine knees (80\%) had flexion to at least 120 degrees . Two patients (two knees) with well-fixed components underwent revision to total knee arthroplasty, at seven and eleven years, because of progression of patellofemoral arthritis. At the time of the final follow-up, no component was loose radiographically and there was no evidence of periprosthetic osteolysis. Radiographic evidence of progressive loss of joint space was observed in the opposite compartment of nine knees (18\%) and in the patellofemoral space of seven knees (14\%). Kaplan-Meier analysis revealed a survival rate of 98.0\% +/- 2.0\% at ten years and of 95.7\% +/- 4.3\% at thirteen years, with revision or radiographic loosening as the end point. The survival rate was 100\% at thirteen years with aseptic loosening as the end point. CONCLUSIONS: After a minimum duration of follow-up of ten years, this cemented modular unicompartmental knee design was associated with excellent clinical and radiographic results. Although the ten-year survival rate was excellent, radiographic signs of progression of osteoarthritis in the other compartments continued at a slow rate. With appropriate indications and technique, this unicompartmental knee design can yield excellent results into the beginning of the second decade of use.
This article was published in J Bone Joint Surg Am
and referenced in Orthopedic & Muscular System: Current Research