Skip to main content

Mobile-Bearing Unicompartmental Knee

  • Reference work entry
  • First Online:
Minimally Invasive Surgery in Orthopedics

Abstract

Anteromedial wear is the most common pattern of knee arthritis in patients with intact ACL. Surgical options in this patient population include high tibial osteotomy (HTO), total knee arthroplasty (TKA), or unicompartmental arthroplasty (UKA). UKA offers the advantage of preserving native knee ligaments, faster recovery from surgery, as well as good short-term and long-term survival. The patellofemoral joint can often be ignored in these patients, with good survivorship of mobile-bearing UKA even in patients with more advanced patellofemoral disease. Traditional indications for UKA have limited this surgery to older, low-demand patients with lower weight. Using more liberal indications, UKA has shown good success in younger, active patients with higher body mass index (BMI). This chapter outlines the indications, surgical technique, and outcomes using a mobile-bearing unicompartmental knee arthroplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 899.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Berend KR, Morris MJ, Lombardi AV. Unicompartmental knee arthroplasty: incidence of transfusion and symptomatic thromboembolic disease. Orthopedics. 2010;33(9 Suppl):8–10.

    Article  PubMed  Google Scholar 

  2. Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della Valle CJ. Total knee arthroplasty has a higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplasty. 2012;27(8 Suppl):86–90.

    Article  PubMed  Google Scholar 

  3. Morris MJ, Molli RG, Berend KR, Lombardi Jr AV. Mortality and perioperative complications after unicompartmental knee arthroplasty. Knee. 2013;20(3):218–20.

    Article  PubMed  Google Scholar 

  4. Lombardi Jr AV, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA. Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res. 2009;467(6):1450–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Laurencin CT, Zelicof SB, Scott RD, Ewald FC. Unicompartmental versus total knee arthroplasty in the same patient: a comparative study. Clin Orthop Relat Res. 1991;273:151–6.

    PubMed  Google Scholar 

  6. 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 prostheses. Acta Orthop Scand. 1999;70(2):170–5.

    Article  CAS  PubMed  Google Scholar 

  7. Jung MC, Chung JY, Son KH, Wang H, Hwang J, Kim JJ, Kim JH, Min BH. Difference in knee rotation between total and unicompartmental knee arthroplasties during stair climbing. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1879–86.

    Article  PubMed  Google Scholar 

  8. Patil S, Colwell Jr CW, Ezzet KA, D’Lima DD. Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am. 2005;87(2):332–8.

    Article  PubMed  Google Scholar 

  9. Berend KR, Berend ME, Hurst JM, Morris MJ, Walburn BJ, Lombardi AV Jr. Does the status of the ACL at the time of primary total knee arthroplasty predict early outcomes? Poster presentation at the American Association of Hip and Knee Surgeons 24th annual meeting, 7–9 Nov, 2014, Dallas.

    Google Scholar 

  10. Ackroyd CE. Medial compartment arthroplasty of the knee. J Bone Joint Surg Br. 2003;85(7):937–42.

    Article  CAS  PubMed  Google Scholar 

  11. Robertsson O, Knutson K, Lewold S, Lidgren L. The Swedish Knee Arthroplasty Register 1975–1997: an update with special emphasis on 41,223 knees operated on in 1988–1997. Acta Orthop Scand. 2001;72(5):503–13.

    Article  CAS  PubMed  Google Scholar 

  12. Kozinn S, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am. 1989;71(1):145–50.

    CAS  PubMed  Google Scholar 

  13. Ritter MA, Faris PM, Thong AE, Davis KE, Meding JB, Berend ME. Intra-operative findings in varus osteoarthritis of the knee: an analysis of pre-operative alignment in potential candidates for unicompartmental arthroplasty. J Bone Joint Surg Br. 2004;86(1):43–7.

    CAS  PubMed  Google Scholar 

  14. Sculco TP. Orthopaedic crossfire – can we justify unicondylar arthroplasty as a temporizing procedure? In opposition. J Arthroplasty. 2002;17(4 Suppl 1):56–8.

    Article  PubMed  Google Scholar 

  15. Stern SH, Becker MW, Insall JN. Unicondylar knee arthroplasty. An evaluation of selection criteria. Clin Orthop Relat Res. 1993;286:143–8.

    PubMed  Google Scholar 

  16. Berend KR, Lombardi Jr AV, Adams JB. Obesity, young age, patellofemoral disease, and anterior knee pain: identifying the unicondylar arthroplasty patient in the United States. Orthopedics. 2007;30(5 Suppl):19–23.

    PubMed  Google Scholar 

  17. Murray DW, Pandit H, Weston-Simons JS, Jenkins C, Gill HS, Lombardi AV, Dodd CA, Berend KR. Does body mass index affect the outcome of unicompartmental knee replacement? Knee. 2013;20(6):461–5.

    Article  CAS  PubMed  Google Scholar 

  18. Berend KR, Lombardi Jr AV, Morris MJ, Hurst JM, Kavolus JJ. Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival? Orthopedics. 2011;34(9):e494–6.

    PubMed  Google Scholar 

  19. Deschamps G, Lapeyre B. Rupture of the anterior cruciate ligament: a frequently unrecognized cause of failure of unicompartmental knee prostheses. Apropos of a series of 79 lotus prostheses with a follow-up of more than 5 years. Rev Chir Orthop Reparatrice Appar Mot. 1987;73(7):544–51.

    CAS  PubMed  Google Scholar 

  20. Mullaji AB, Marawar SV, Luthra M. Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty. 2008;23(1):128–35.

    Article  PubMed  Google Scholar 

  21. Weston-Simons JS, Pandit H, Jenkins C, Jackson WF, Price AJ, Gill HS, Dodd CA, Murray DW. Outcome of combined unicompartmental knee replacement and combined or sequential anterior cruciate ligament reconstruction: a study of 52 cases with mean follow-up of five years. J Bone Joint Surg Br. 2012;94(9):1216–20.

    Article  CAS  PubMed  Google Scholar 

  22. Berend KR, Lombardi Jr AV. The medial unicompartmental option: mobile magic. Semin Arthroplasty. 2009;20:11–4.

    Article  Google Scholar 

  23. Lisowski LA, van den Bekerom MP, Pilot P, van Dijk CN, Lisowski AE. Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):277–84.

    Article  PubMed  Google Scholar 

  24. Pandit H, Jenkins C, Barker K, Dodd CA, Murray DW. The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Joint Surg Br. 2006;88(1):54–60.

    Article  CAS  PubMed  Google Scholar 

  25. Clement ND, Duckworth AD, MacKenzie SP, Nie YX, Tiemessen CH. Medium-term results of Oxford phase-3 medial unicompartmental knee arthroplasty. J Orthop Surg (Hong Kong). 2012;20(2):157–61.

    Google Scholar 

  26. Faour-Martín O, Valverde-García JA, Martín-Ferrero MA, Vega-Castrillo A, de la Red Gallego MA, Suárez de Puga CC, Amigo-Liñares L. Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results. Int Orthop. 2013;37(5):833–8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Emerson Jr RH, Higgins LL. Unicompartmental knee arthroplasty with the Oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am. 2008;90(1):118–22.

    Article  PubMed  Google Scholar 

  28. Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Murray DW. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg Br. 2011;93(2):198–204.

    Article  CAS  PubMed  Google Scholar 

  29. Price AJ, Svard U. A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2011;469(1):174–9.

    Article  PubMed  Google Scholar 

  30. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop. 2010;34(8):1137–43.

    Article  PubMed  Google Scholar 

  31. Kort NP, van Raay JJ, van Horn JJ. The Oxford phase III unicompartmental knee replacement in patients less than 60 years of age. Knee Surg Sports Traumatol Arthrosc. 2007;15(4):356–60.

    Article  PubMed  Google Scholar 

  32. Streit MR, Streit J, Walker T, Bruckner T, Philippe Kretzer J, Ewerbeck V, Merle C, Aldinger PR, Gotterbarm T. Minimally invasive Oxford medial unicompartmental knee arthroplasty in young patients. Knee Surg Sports Traumatol Arthrosc. 2015 May 10 [Epub ahead of print].

    Google Scholar 

  33. Price AJ, Dodd CA, Svard UG, Murray DW. Oxford medial unicompartmental knee arthroplasty in patients younger and older than 60 years of age. J Bone Joint Surg Br. 2005;87(11):1488–92.

    Article  CAS  PubMed  Google Scholar 

  34. Pietschmann MF, Wohlleb L, Weber P, Schmidutz F, Ficklscherer A, Gülecyüz MF, Safi E, Niethammer TR, Jansson V, Müller PE. Sports activities after medial unicompartmental knee arthroplasty Oxford III-what can we expect? Int Orthop. 2013;37(1):31–7.

    Article  PubMed  Google Scholar 

  35. Small SR, Berend ME, Ritter MA, Buckley CA. Bearing mobility affects tibial strain in mobile-bearing unicompartmental knee arthroplasty. Surg Technol Int. 2010;19:185–90.

    PubMed  Google Scholar 

  36. Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA. Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplasty. 2006;21(6, Suppl 2):108–15.

    Article  PubMed  Google Scholar 

  37. Knight JL, Atwater RD, Guo J. Early failure of the porous coated anatomic cemented unicompartmental knee arthroplasty. Aids to diagnosis and revision. J Arthroplasty. 1997;12(1):11–20.

    Article  CAS  PubMed  Google Scholar 

  38. Whittaker JP, Naudie DD, McAuley JP, McCalden RW, MacDonald SJ, Bourne RB. Does bearing design influence midterm survivorship of unicompartmental arthroplasty? Clin Orthop Relat Res. 2010;468(1):73–81.

    Article  PubMed  Google Scholar 

  39. Argenson JN, O’Connor JJ. Polyethylene wear in meniscal knee replacement: a one to nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg Br. 1992;74(2):228–32.

    CAS  PubMed  Google Scholar 

  40. Kendrick BJ, Longino D, Pandit H, Svard U, Gill HS, Dodd CA, Murray DW, Price AJ. Polyethylene wear in Oxford unicompartmental knee replacement: a retrieval study of 47 bearings. J Bone Joint Surg Br. 2010;92(3):367–73.

    Article  CAS  PubMed  Google Scholar 

  41. Price AJ, Short A, Kellett C, Beard D, Gill H, Pandit H, Dodd CA, Murray DW. Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty. J Bone Joint Surg Br. 2005;87(11):1493–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David A. Crawford .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland (outside the USA)

About this entry

Cite this entry

Crawford, D.A., Berend, K.R. (2016). Mobile-Bearing Unicompartmental Knee. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-319-34109-5_54

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-34109-5_54

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34107-1

  • Online ISBN: 978-3-319-34109-5

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics