Medial unicompartmental knee arthroplasty improves congruence and restores joint space width of the lateral compartment

The Knee ◽  
2016 ◽  
Vol 23 (3) ◽  
pp. 501-505 ◽  
Author(s):  
Saker Khamaisy ◽  
Hendrik A. Zuiderbaan ◽  
Jelle P. van der List ◽  
Denis Nam ◽  
Andrew D. Pearle
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Space Width

Quantitative Evaluation of Joint Space Width in the Lateral Compartment after Medial Unicompartmental Knee Arthroplasty: Comparison of Three Radiographic Views

2017 ◽  
Vol 31 (08) ◽  
pp. 730-735
Author(s):  
Ju'an Yue ◽  
Wanshou Guo ◽  
Fuyin Wan ◽  
Pengfei Wen ◽  
Zhaohui Liu ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Valgus Stress ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group A ◽  
Group B ◽  
Space Width

AbstractLateral compartment cartilage deterioration is the most common complication affecting medial unicompartmental knee arthroplasty (UKA) survivorship. The purpose of this study was to determine the best method of judging the degeneration of cartilage in the lateral compartment after medial UKA through analysis of different radiographic views. Forty-two participants were divided into two groups. Patients in Group A were followed for at least 10 months after undergoing a medial UKA (mean: 17.67 ± 7.65 months, range: 10–24 months), whereas those in Group B were evaluated 3 days after surgery. Joint space width in the lateral compartment of all patients was evaluated using three types of knee radiographs: weight-bearing anterior posterior (AP), supine AP, and supine valgus stress. No difference in joint space width in the lateral compartment after medial UKA was found for the three kinds of radiographs in Group A (F = 0.97, p = 0.39) and Group B (F = 1.499, p = 0.233). After evaluating the patients 3 days after surgery or following them for approximately 18 months after medial UKA, we determined that weight-bearing AP, supine AP, and supine valgus stress knee radiographs were comparable when used to assess residual cartilage thickness of the lateral compartment.

scholarly journals Unicompartmental Knee Arthroplasties are Performed on the Patients with Radiologically Too Mild Osteoarthritis

2017 ◽  
Vol 106 (4) ◽  
pp. 338-341 ◽  
Author(s):  
J. Knifsund ◽  
J. Hatakka ◽  
H. Keemu ◽  
K. Mäkelä ◽  
M. Koivisto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Joint Space Width ◽  
Joint Space ◽  
Phase Iii ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
The Mean ◽  
Space Width

Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates. Aims: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty. Methods: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years. Results and Conclusion: The knees with a preoperative Kellgren–Lawrence grade of 0–2 osteoarthritis had a higher risk of reoperation than those with a Kellgren–Lawrence grade of 3–4 (odds ratio = 1.89; 95% confidence interval, 1.03–3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.

scholarly journals Mobile Versus Fixed Bearing Medial Unicompartmental Knee Arthroplasty: A Series of 375 Patients

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Robert Murphy ◽  
Tyler Fraser ◽  
William Mihalko
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mobile Bearing ◽  
Lateral Compartment ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Component Loosening

Introduction: We sought to compare outcomes, complications and survival between mobile and fixed bearing medial unicompartmental knee arthroplasty (UKA) in a large multi-surgeon group.Methods: Medical records of patients who underwent a medial UKA were queried between March 2003 and August 2012. Variables investigated included final range of motion (ROM), type of complication, and overall survivorship. Results: 375 medial UKAs were analyzed (308 mobile bearing and 67 fixed bearing). Average time to follow-up was 47 months. Final ROM was comparable (mobile: 1-122°, fixed: 1-120°, p = 0.34). Complications occurred in 20/308 (6.6%) mobile bearing UKA and 5/67 (7.5%) fixed bearing UKA (p = 0.77). The most common complications in mobile bearing implants were progression of lateral compartment disease and component loosening. The complications in fixed bearing implants were arthrofibrosis and tibial plateau fracture. Overall survivorship differed, but not significantly (mobile: 94.8%, fixed: 96.9%, p = 0.44). Discussion: In this largest reported cohort series comparing mobile versus fixed bearing UKA, we found no significant difference in final clinical knee range of motion, rates of complications, and survivorship between the two bearing types. 

scholarly journals Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment

2018 ◽  
Vol 7 (1) ◽  
pp. 20-27 ◽  
Author(s):  
K-T. Kang ◽  
J. Son ◽  
D-S. Suh ◽  
S. K. Kwon ◽  
O-R. Kwon ◽  
...  
Keyword(s):  
Finite Element ◽  
Articular Cartilage ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Lateral Compartment ◽  
Contact Stresses ◽  
Patient Specific ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Biomechanical Effect

Objectives Patient-specific (PS) implantation surgical technology has been introduced in recent years and a gradual increase in the associated number of surgical cases has been observed. PS technology uses a patient’s own geometry in designing a medical device to provide minimal bone resection with improvement in the prosthetic bone coverage. However, whether PS unicompartmental knee arthroplasty (UKA) provides a better biomechanical effect than standard off-the-shelf prostheses for UKA has not yet been determined, and still remains controversial in both biomechanical and clinical fields. Therefore, the aim of this study was to compare the biomechanical effect between PS and standard off-the-shelf prostheses for UKA. Methods The contact stresses on the polyethylene (PE) insert, articular cartilage and lateral meniscus were evaluated in PS and standard off-the-shelf prostheses for UKA using a validated finite element model. Gait cycle loading was applied to evaluate the biomechanical effect in the PS and standard UKAs. Results The contact stresses on the PE insert were similar for both the PS and standard UKAs. Compared with the standard UKA, the PS UKA did not show any biomechanical effect on the medial PE insert. However, the contact stresses on the articular cartilage and the meniscus in the lateral compartment following the PS UKA exhibited closer values to the healthy knee joint compared with the standard UKA. Conclusion The PS UKA provided mechanics closer to those of the normal knee joint. The decreased contact stress on the opposite compartment may reduce the overall risk of progressive osteoarthritis. Cite this article: K-T. Kang, J. Son, D-S. Suh, S. K. Kwon, O-R. Kwon, Y-G. Koh. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: A Finite Element Analysis. Bone Joint Res 2018;7:20–27. DOI: 10.1302/2046-3758.71.BJR-2017-0115.R2.

Bone-on-Bone Contact on Radiograph is not a Prerequisite for Successful Outcome in Fixed-Bearing Medial Unicompartmental Knee Arthroplasty—A 10-Year Follow-Up Study

2021 ◽  
Author(s):  
Khai Cheong Wong ◽  
Merrill Lee ◽  
Lincoln Liow ◽  
Ngai-Nung Lo ◽  
Seng-Jin Yeo ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Short Form ◽  
Oxford Knee Score ◽  
Joint Space ◽  
Functional Score ◽  
Knee Score ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Medial Unicompartmental Knee Arthroplasty

Abstract Introduction Patients without bone-on-bone osteoarthritis are excluded from mobile-bearing unicompartmental knee arthroplasty due to higher revision rates and poorer outcomes. However, we do not know if the same indication applies to fixed-bearing unicompartmental knee arthroplasty implants. Our study aims to compare functional outcomes and revision rates in patients with and without bone-on-bone arthritis undergoing fixed-bearing medial unicompartmental knee arthroplasty. Materials and Methods We reviewed 153 fixed-bearing medial unicompartmental knee arthroplasties in a single institution. Patients were divided into four groups based on joint space remaining measured on preoperative radiographs. Group 1 included knees with bone-on-bone contact; group 2 included knees with less than 2 mm joint space; group 3 included knees with 2 to 4 mm joint space; group 4 included knees with more than 4 mm joint space. Patients were followed up for 10 years postoperatively and assessed using the Oxford Knee Score, the Functional Score and Knee Score from the Knee Society Clinical Rating Score, and the Short Form 36 Health Survey. Results There was no difference in terms of demographic data and preoperative scores. Postoperative Knee Society Functional Score was found to be lower in group 1 as compared with the other groups. There was no difference between the four groups of patients in terms of Knee Society Knee Score, Oxford Knee Score, and Physical Component Summary and Mental Component Summary Scores from the Short Form 36 Health Survey. There was no difference in terms of survivorship free from all-cause revision at a minimum of 10 years' follow-up. Conclusion Symptomatic patients with varying degrees of arthritis on preoperative radiographs had comparable clinical outcomes. We conclude that symptomatic patients with clinical and radiographic evidence of medial compartment osteoarthritis of any grade can benefit from a fixed-bearing medial unicompartmental knee arthroplasty.

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