Abstract
Purpose
Unicompartmental knee prostheses with screw fixation into the proximal tibia were employed and postoperative clinical results for osteoarthritis of the knee, especially regarding relief of pain, range of motion and satisfactory limb alignment are reported and discussed.
Methods
A total of 140 knees (131 medial and 9 lateral) of 85 patients (21 men and 64 women) were followed up for two to 17 years with an average of 7.0 ± 3.0 years.
Results
In spite of loss to follow-up in three knees of two patients and revision to total knee arthroplasty in one knee of one patient, in the remaining 136 knees (82 patients) the mean knee score of the Knee Society Clinical Rating System was 41.0 ± 14.7 pre-operatively, which improved to 93.1 ± 5.7 at follow-up, while the mean functional score similarly improved from 36.9 ± 8.1 to 88.5 ± 6.3 (p < 0.001 respectively). One knee developed a fracture in the medial proximal part of the tibia, but no knee developed loosening of the prosthesis or infection. The mean pre-operative knee flexion was 122.6 ± 15.9°, which improved to 132.9 ± 13.4° (p < 0.001) at follow-up. The limb alignment showed 4.8 ± 4.5° anatomical varus angulation pre-operatively, which was corrected to 5.8 ± 3.3° valgus at follow-up in the medial unicompartmental replacement group (127 knees), and 19 ± 6.1° valgus pre-operatively, which was corrected to 6.7 ± 3.0° valgus at follow-up in the lateral unicompartmental replacement group (nine knees).
Conclusions
The clinical results of arthroplasty with screw fixation were concluded to be promising.
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References
Insall J, Walker P (1976) Unicondylar knee replacement. Clin Orthop 120:83–85
Kendrick BJ, Simpson DJ, Kaptein BL et al (2011) Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years. J Bone Joint Surg Br 93:470–475
Jonsson GT (1982) Compartmental arthroplasty for gonarthrosis. Acta Orthop Scand Suppl 193:60–65
Luscombe KL, Lim J, Jones PW, White SH (2007) Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! Int Orthop 31:321–324
Knutson K, Jonsson GT, Langer Andersen J et al (1981) Deformation and loosening of the tibial component in knee arthroplasty with unicompartmental endoprostheses. Acta Orthop Scand 52:667–673
Psychoyios V, Crawford RW, O’Connor JJ, Murray DW (1998) Wear of congruent meniscal bearings in unicompartmental knee arthroplasty: a retrieval study of 16 specimens. J Bone Joint Surg Br 80:976–982
Koshino T, Morii T (1987) Clinical results of ceramic unicondylar knee replacement (Koshino’s Ceramic Unicon YMCK). In: Vincenzini P (ed) High tech ceramics. Elsevier, Amsterdam, pp 351–360
Koshino T, Morii T, Wada J, Takahashi S (1991) Unicompartmental replacement with Marmor modular knee: operative procedure and results. Bull Hosp Jt Dis Orthop Inst 51:119–131
Koshino T (1997) Unicompartmental arthroplasty of degenerative osteoarthritic knee, with more than 10-years’ follow-up. In: Cartier PH, Epinette JA, Deschamps G et al (eds) Unicompartmental knee arthroplasty. Expension Scientifique Grandale, Paris, p 200
Price AJ, Waite JC, Svard U (2005) Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop 435:171–180
Cartier P, Sanouiller J-L, Grelsamer RP (1996) Unicompartmental knee arthroplasty surgery: 10-year minimum follow-up period. J Arthroplasty 11:782–788
Keys GW, UI-Abiddin Z, Toh EM (2004) Analysis of first forty Oxford medial unicompartmental knee replacement from a small district hospital in UK. Knee 11:375–377
Marmor L (1976) The modular (Marmor) knee: case report with a minimum follow-up of 2 years. Clin Orthop 120:86–94
Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) 277(Suppl):7–72
Koshino T, Yoshida T, Ara Y, Saito I, Saito T (2004) Fifteen to twenty-eight years’ follow-up results of high tibial valgus osteotomy for osteoarthritic knee. Knee 11:439–444
Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM (2002) Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. J Bone Joint Surg Am 84:2235–2239
Pandit H, Jenkins C, Gill HS, Barker K, Dodd CAF, Murray DW (2011) Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg Br 93:198–204
Laskin RS (1978) Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am 60:182–185
Koshinen E, Paavolainen P, Eskelinen A, Harilainen A, Sandelin J, Ylinen P et al (2009) Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: mid-term clinical and radiographic results. Arch Orthop Trauma Surg 129:617–624
Emerson RH Jr, Higgins LL (2008) Unicompartmental knee arthroplasty with the Oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 90:118–122
Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 80:983–989
Hasegawa Y, Ooishi Y, Shimizu T et al (1998) Unicompartmental knee arthroplasty for medial gonarthrosis: 5 to 9 years follow-up evaluation of 77 knees. Arch Orthop Trauma Surg 117:183–187
Lisowski LA, van den Bekerom MPJ, Pilot P, van Dijk CN, Lisowski AE (2011) Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure. Knee Surg Sports Traumatol Arthrosc 19:277–284
Niinimaki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI (2011) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 18:432–435
Koshino T, Tsuchiya T (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. Clinical and histological observations. Int Orthop 3:37–45
Mercier N, Wimsey S, Saragaglia D (2010) Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop 34:1137–1143
Cross MB, Berger R (2014) Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop 38:443–447
Citak M, Dersch K, Kamath AF, Haasper C, Gehrke T, Kendoff D (2014) Common causes of failed unicompartmental knee arthroplasty: a single-centre analysis of four hundred and seventy one cases. Int Orthop 38:961–965
Acknowledgments
The authors wish to express heartfelt appreciation to members and staff in the Department of Orthopaedic Surgery, Yokohama City University School of Medicine, especially Dr. S. Takagawa, for their kind assistance in surgeries.
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The authors declare that they have no conflict of interest.
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Koshino, T., Sato, K., Umemoto, Y. et al. Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation. International Orthopaedics (SICOT) 39, 1085–1091 (2015). https://doi.org/10.1007/s00264-014-2564-y
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DOI: https://doi.org/10.1007/s00264-014-2564-y