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High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To determine the medium-term implant survivorship, the clinical results and the failure mechanisms of a novel unicompartmental arthroplasty for uncemented resurfacing of the medial tibio-femoral compartment.

Methods

Seventy-six consecutive patients were prospectively evaluated with a mean final follow-up of 6 years (SD 5.3 months). In 44 patients, the diagnosis was osteoarthritis, and in 32 patients, it was avascular necrosis of the medial femoral condyle. The Hospital for Special Surgery Score was used for objective clinical evaluation, and a self-administered visual analogue scale was used to quantify residual pain at each observation point. Implant survivorship was determined assuming revision for any reason as endpoint.

Results

Nineteen patients were revised (6 with osteoarthritis and 13 with avascular necrosis of the medial femoral condyle). The mean interval time from index surgery to revision was 11.2 months (SD 4.66 months). Implant survivorship was higher in patients with osteoarthritis with respect to those with avascular necrosis of the medial femoral condyle (p = 0.018). Aseptic loosening was the most frequent failure mechanism. Femoral component loosening was reported in five patients and tibial component loosening was reported in other six patients. Assuming revision for any reason as endpoint, an implant survivorship of 74.3 % at 6-year follow-up was determined. In the remaining 57 patients, satisfactory clinical results were obtained. Hospital for Special Surgery Score and visual analogue scale for residual pain showed significant improvements (p < 0.03 and p < 0.045, respectively).

Conclusions

At the present time, the standard cemented implants and the conventional designs for unicompartmental knee replacement still represent the optimal solution. The authors do not recommend the widespread use of this technique.

Level of evidence

IV.

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Acknowledgments

The authors want to thank Simone Bignozzi, PhD, Ibrahim Akkawi, MD, and Michele Gagliardi, MD, for their precious help in statistical analysis and data collection.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 2nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy

    Danilo Bruni, Stefano Zaffagnini, Francesco Iacono, Mirco Lo Presti, Maria Pia Neri, Giulio Maria Marcheggiani Muccioli, Marco Nitri, Giovanni Raspugli & Maurilio Marcacci

  2. Biomechanics and Technologic Innovation Laboratory, Codivilla-Putti Research Center, Via di Barbiano 1/10, 40136, Bologna, Italy

    Danilo Bruni, Laura Bragonzoni & Maurilio Marcacci

  3. Bologna University, Bologna, Italy

    Danilo Bruni, Laura Bragonzoni & Maurilio Marcacci

Authors
  1. Danilo Bruni
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  2. Stefano Zaffagnini
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  3. Francesco Iacono
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  4. Laura Bragonzoni
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  5. Mirco Lo Presti
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  6. Maria Pia Neri
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  7. Giulio Maria Marcheggiani Muccioli
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  8. Marco Nitri
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  9. Giovanni Raspugli
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  10. Maurilio Marcacci
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Corresponding author

Correspondence to Danilo Bruni.

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Bruni, D., Zaffagnini, S., Iacono, F. et al. High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 24, 3175–3182 (2016). https://doi.org/10.1007/s00167-014-3444-0

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  • DOI: https://doi.org/10.1007/s00167-014-3444-0

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