Lateral Unicompartmental Knee Arthroplasty for the Treatment of Lateral Knee Osteoarthritis. Results in 29 Arthroplasties with an Average Follow-up of 6.2 Years
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Published:
Jun 15, 2021
Keywords:
Unicompartmental knee arthroplasty, lateral, lateral knee osteoarthritis, knee arthroplasty, unicompartmental replacement
Main Article Content
Abstract
Objective: The purpose of this article is to examine the medium-term functional outcomes and survivorship of lateral unicompartmental knee arthroplasty in the treatment of lateral knee osteoarthritis.
Materials and Methods: Retrospective report. We selected and analyzed all patients who had undergone a lateral unicompartmental knee arthroplasty for the treatment of lateral knee osteoarthritis between January 1999 and January 2019, with a minimum follow-up of 1 year. The KSS score system 2011, the Kellgren-Lawrence osteoarthritis classification, the Outerbridge femoropatellar chondropathy classification and serial radiographs were used in the evaluation of each patient. The complication and prosthesis survivorship rates were assessed.
Results: We identified 29 lateral unicompartmental knee arthroplasties in 27 patients with a follow-up of 6.2 years (1-19.5). The clinical and functional KSS improved from 56.5 ± 9.8 to 91.9 ± 5.3 and 33.9 ± 13.7 to 91.4 ± 10.3 respectively (p<0.001). Postoperative maximal flexion improved from 106º ± 6.7º to 124.2º ± 2.4º and flexion contracture improved from 5.2º ± 3.2º to 1º ± 1.6º (p<0.001). The average preoperative alignment was 12.3º ± 4.1º of valgus angulation, which was corrected to 5.2º ± 3.1º of valgus (p<0.001). The survivorship rate was 100% and only one patient showed osteoarthritic changes in the medial compartment (3.4%).
Conclusion: Lateral unicompartmental knee arthroplasty provides excellent medium-term results. It represents a reliable and definitive option in the treatment of the isolated lateral knee osteoarthritis.
Materials and Methods: Retrospective report. We selected and analyzed all patients who had undergone a lateral unicompartmental knee arthroplasty for the treatment of lateral knee osteoarthritis between January 1999 and January 2019, with a minimum follow-up of 1 year. The KSS score system 2011, the Kellgren-Lawrence osteoarthritis classification, the Outerbridge femoropatellar chondropathy classification and serial radiographs were used in the evaluation of each patient. The complication and prosthesis survivorship rates were assessed.
Results: We identified 29 lateral unicompartmental knee arthroplasties in 27 patients with a follow-up of 6.2 years (1-19.5). The clinical and functional KSS improved from 56.5 ± 9.8 to 91.9 ± 5.3 and 33.9 ± 13.7 to 91.4 ± 10.3 respectively (p<0.001). Postoperative maximal flexion improved from 106º ± 6.7º to 124.2º ± 2.4º and flexion contracture improved from 5.2º ± 3.2º to 1º ± 1.6º (p<0.001). The average preoperative alignment was 12.3º ± 4.1º of valgus angulation, which was corrected to 5.2º ± 3.1º of valgus (p<0.001). The survivorship rate was 100% and only one patient showed osteoarthritic changes in the medial compartment (3.4%).
Conclusion: Lateral unicompartmental knee arthroplasty provides excellent medium-term results. It represents a reliable and definitive option in the treatment of the isolated lateral knee osteoarthritis.
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How to Cite
Gaggiotti, G., Gaggiotti, S., & Ringa, J. C. (2021). Lateral Unicompartmental Knee Arthroplasty for the Treatment of Lateral Knee Osteoarthritis. Results in 29 Arthroplasties with an Average Follow-up of 6.2 Years. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(3), 299-308. https://doi.org/10.15417/issn.1852-7434.2021.86.3.1211
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Clinical Research
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References
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5. Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty 2008;23(3):408-12. https://doi.org/10.1016/j.arth.2007.04.012
6. Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and
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8. Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Lateral unicompartmental knee arthroplasty: Survivorship and technical considerations at an average follow-up of 12.4 years. J Arthroplasty 2006;21(1):13-7.
https://doi.org/10.1016/j.arth.2004.11.021
9. Argenson JNA, Parratte S, Bertani A, Flecher X, Aubaniac JM. Long-term results with a lateral unicondylar
replacement. Clin Orthop Relat Res 2008;466(11):2686-93. https://doi.org/10.1007/s11999-008-0351-z
10. Marmor L. Lateral compartment arthroplasty of the knee. Clin Orthop Relat Res 1984;186(4):115-21.
https://doi.org/10.1097/00003086-198406000-00019
11. Ollivier M, Abdel MP, Parratte S, Argenson JN. Lateral unicondylar knee arthroplasty (UKA): Contemporary
indications, surgical technique, and results. Int Orthop 2014;38(2):449-55. https://doi.org/10.1007/s00264-013-2222-9
12. Servien E, Merini A, Lustig S, Neyret P. Lateral uni-compartmental knee replacement: Current concepts and future directions. Knee Surg Sport Traumatol Arthrosc 2013;21(11):2501-8. https://doi.org/10.1007/s00167-013-2585-x
13. Berend KR, Kolczun MC, George JW, Lombardi A V. Lateral unicompartmental knee arthroplasty through a lateral parapatellar approach has high early survivorship. Clin Orthop Relat Res 2012;470(1):77-83.
https://doi.org/10.1007/s11999-011-2005-9
14. O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, et al. Unicompartmental knee
replacement: A minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res 2005;(440):27-37.
https://doi.org/10.1097/01.blo.0000185451.96987.aa
15. Heyse TJ, Khefacha A, Peersman G, Cartier P. Survivorship of UKA in the middle-aged. Knee 2012;19(5):585-91.
https://doi.org/10.1016/j.knee.2011.09.002
16. Hamilton TW, Pandit HG, Jenkins C, Mellon SJ, Dodd CAF, Murray DW. Evidence-based indications for
mobile-bearing unicompartmental knee arthroplasty in a consecutive cohort of thousand knees. J Arthroplasty
2017;32(6):1779-85. https://doi.org/10.1016/j.arth.2016.12.036
17. Lustig S, Lording T, Frank F, Debette C, Servien E, Neyret P. Progression of medial osteoarthritis and long
term results of lateral unicompartmental arthroplasty: 10 to 18 year follow-up of 54 consecutive implants. Knee
2014;21(1):26-32. https://doi.org/10.1016/S0968-0160(14)50006-3
18. Sah AP, Scott RD. Lateral unicompartmental knee arthroplasty through a medial approach: Study with an average five-year follow-up. J Bone Joint Surg Am 2007;89(9):1948-54. https://doi.org/10.2106/JBJS.F.01457
19. Ohdera T, Tokunaga J, Kobayashi A. Unicompartmental knee arthroplasty for lateral gonarthrosis: Midterm results. J Arthroplasty 2001;16(2):196-200. https://doi.org/10.1054/arth.2001.2090
20. Edmiston TA, Manista GC, Courtney PM, Sporer SM, Della Valle CJ, Levine BR. Clinical outcomes and
survivorship of lateral unicompartmental knee arthroplasty: Does surgical approach matter? J Arthroplasty
2018;33(2):362-5. https://doi.org/10.1016/j.arth.2017.09.009
21. Ashraf T, Newman JH, Evans RL, Ackroyd CE. Lateral unicompartmental knee replacement survivorship and
clinical experience over 21 years. J Bone Joint Surg Br 2002;84(8):1126-30. https://doi.org/10.1302/0301-620x.84b8.13447
22. Thienpont E. Conversion of a unicompartmental knee arthroplasty to a total knee arthroplasty can we achieve a primary result? Bone Joint J 2017;99B(1):65-9. https://doi.org/10.1302/0301-620X.99B1.BJJ-2016-0272
23. Leta TH, Lygre SHL, Skredderstuen A, Hallan G, Gjertsen JE, Rokne B, et al. Outcomes of unicompartmental
knee arthroplasty after aseptic revision to total knee arthroplasty a comparative study of 768 TKAs and 578 UKAs
revised to TKAs from the norwegian arthroplasty register (1994 to 2011). J Bone Joint Surg Am 2016;98(6):431-40.
https://doi.org/10.2106/JBJS.O.00499
24. Pinskerova V, Johal P, Nakagawa S, Sosna A, Williams A, Gedroyc W, et al. Does the femur roll-back with flexion? J Bone Joint Surg Br 2004;86(6):925-31. https://doi.org/10.1302/0301-620x.86b6.14589
25. Gunther TV, Murray DW, Miller R, Wallace DA, Carr AJ, O’Connor JJ, et al. Lateral unicompartmental arthroplasty with the Oxford meniscal knee. Knee 1996;3(1-2):33-9. https://doi.org/10.1016/0968-0160(96)00208-6
2. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am 1980;62(8):
1329-37. https://doi.org/10.2106/00004623-198062080-00013
3. Cartier P, Gaggiotti G, Jully JL. Primary osteonecrosis of the medial femoral condyle. Unicompartmental or total
replacement? Int Orthop 1988;12(3):229-35. https://doi.org/10.1007/BF00547168
4. Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 1996;11(7):782-8. https://doi.org/10.1016/s0883-5403(96)80177-x
5. Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty 2008;23(3):408-12. https://doi.org/10.1016/j.arth.2007.04.012
6. Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and
total knee arthroplasties: A propensity score-matched analysis. J Arthroplasty 2017;32(5):1453-9.
https://doi.org/10.1016/j.arth.2016.11.034
7. Robertsson O, Borgquist L, Knutson K, Lewold S, Lidgren L. Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental pros. Acta Orthop Scand 1999;70(2):170-5. https://doi.org/10.3109/17453679909011257
8. Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Lateral unicompartmental knee arthroplasty: Survivorship and technical considerations at an average follow-up of 12.4 years. J Arthroplasty 2006;21(1):13-7.
https://doi.org/10.1016/j.arth.2004.11.021
9. Argenson JNA, Parratte S, Bertani A, Flecher X, Aubaniac JM. Long-term results with a lateral unicondylar
replacement. Clin Orthop Relat Res 2008;466(11):2686-93. https://doi.org/10.1007/s11999-008-0351-z
10. Marmor L. Lateral compartment arthroplasty of the knee. Clin Orthop Relat Res 1984;186(4):115-21.
https://doi.org/10.1097/00003086-198406000-00019
11. Ollivier M, Abdel MP, Parratte S, Argenson JN. Lateral unicondylar knee arthroplasty (UKA): Contemporary
indications, surgical technique, and results. Int Orthop 2014;38(2):449-55. https://doi.org/10.1007/s00264-013-2222-9
12. Servien E, Merini A, Lustig S, Neyret P. Lateral uni-compartmental knee replacement: Current concepts and future directions. Knee Surg Sport Traumatol Arthrosc 2013;21(11):2501-8. https://doi.org/10.1007/s00167-013-2585-x
13. Berend KR, Kolczun MC, George JW, Lombardi A V. Lateral unicompartmental knee arthroplasty through a lateral parapatellar approach has high early survivorship. Clin Orthop Relat Res 2012;470(1):77-83.
https://doi.org/10.1007/s11999-011-2005-9
14. O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, et al. Unicompartmental knee
replacement: A minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res 2005;(440):27-37.
https://doi.org/10.1097/01.blo.0000185451.96987.aa
15. Heyse TJ, Khefacha A, Peersman G, Cartier P. Survivorship of UKA in the middle-aged. Knee 2012;19(5):585-91.
https://doi.org/10.1016/j.knee.2011.09.002
16. Hamilton TW, Pandit HG, Jenkins C, Mellon SJ, Dodd CAF, Murray DW. Evidence-based indications for
mobile-bearing unicompartmental knee arthroplasty in a consecutive cohort of thousand knees. J Arthroplasty
2017;32(6):1779-85. https://doi.org/10.1016/j.arth.2016.12.036
17. Lustig S, Lording T, Frank F, Debette C, Servien E, Neyret P. Progression of medial osteoarthritis and long
term results of lateral unicompartmental arthroplasty: 10 to 18 year follow-up of 54 consecutive implants. Knee
2014;21(1):26-32. https://doi.org/10.1016/S0968-0160(14)50006-3
18. Sah AP, Scott RD. Lateral unicompartmental knee arthroplasty through a medial approach: Study with an average five-year follow-up. J Bone Joint Surg Am 2007;89(9):1948-54. https://doi.org/10.2106/JBJS.F.01457
19. Ohdera T, Tokunaga J, Kobayashi A. Unicompartmental knee arthroplasty for lateral gonarthrosis: Midterm results. J Arthroplasty 2001;16(2):196-200. https://doi.org/10.1054/arth.2001.2090
20. Edmiston TA, Manista GC, Courtney PM, Sporer SM, Della Valle CJ, Levine BR. Clinical outcomes and
survivorship of lateral unicompartmental knee arthroplasty: Does surgical approach matter? J Arthroplasty
2018;33(2):362-5. https://doi.org/10.1016/j.arth.2017.09.009
21. Ashraf T, Newman JH, Evans RL, Ackroyd CE. Lateral unicompartmental knee replacement survivorship and
clinical experience over 21 years. J Bone Joint Surg Br 2002;84(8):1126-30. https://doi.org/10.1302/0301-620x.84b8.13447
22. Thienpont E. Conversion of a unicompartmental knee arthroplasty to a total knee arthroplasty can we achieve a primary result? Bone Joint J 2017;99B(1):65-9. https://doi.org/10.1302/0301-620X.99B1.BJJ-2016-0272
23. Leta TH, Lygre SHL, Skredderstuen A, Hallan G, Gjertsen JE, Rokne B, et al. Outcomes of unicompartmental
knee arthroplasty after aseptic revision to total knee arthroplasty a comparative study of 768 TKAs and 578 UKAs
revised to TKAs from the norwegian arthroplasty register (1994 to 2011). J Bone Joint Surg Am 2016;98(6):431-40.
https://doi.org/10.2106/JBJS.O.00499
24. Pinskerova V, Johal P, Nakagawa S, Sosna A, Williams A, Gedroyc W, et al. Does the femur roll-back with flexion? J Bone Joint Surg Br 2004;86(6):925-31. https://doi.org/10.1302/0301-620x.86b6.14589
25. Gunther TV, Murray DW, Miller R, Wallace DA, Carr AJ, O’Connor JJ, et al. Lateral unicompartmental arthroplasty with the Oxford meniscal knee. Knee 1996;3(1-2):33-9. https://doi.org/10.1016/0968-0160(96)00208-6