Abstract
Purpose Patients with severe deformity beyond the standard indications for unicompartmental knee arthroplasty (UKA) may be suitable and benefit from UKA. This study investigated their outcomes to determine whether good function and quality of life (QOL) can be achieved.
Materials and methods
Fifty-three patients with severe deformity (40 patients with FFD ≥15° and 13 patients with varus deformity ≥15°, Group A) were matched with 53 patients with less severe deformities who underwent UKA (Group B/controls) in terms of age, sex, BMI and duration of follow-up. Their flexion range, Knee Society scores (KSS), Oxford knee scores (OKS) and SF-36 QOL scores were analysed pre-operatively and at 2 years.
Results
Group A patients were largely similar to Group B patients pre-operatively in terms of maximum flexion angle, OKS and SF-36 scores except for knee score and mental health component of SF-36. At 2 years, Group A reported largely similar results compared with Group B in all outcome scores (OKS, KSS, SF-36) and flexion angle. Post-operative mechanical alignment was better for the control group though it is not statistically significant. There were no revisions in the patients with severe pre-operative deformity at 5 years post-operatively. (Survivorship 100 % at 5 years).
Conclusion
Selected patients with severe deformity can achieve good function and QOL with UKA if satisfactory mechanical alignment is restored. This study supports a broadening of the indications of UKA; however, further follow-up is needed to assess the longer-term durability of the operation.
Level of evidence
IV.
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References
Beard DJ, Pandit H, Gill HS et al (2007) The influence of the presence and severity of pre-existing patellofemoral degenerative changes on the outcome of the Oxford medial unicompartmental knee replacement. J Bone Joint Surg [Br] 89-B:1597–1601
Beard DJ, Pandit H, Ostlere S et al (2007) Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg [Br] 89-B:1602–1607
Boyd Joel L, Kurtenbach Chad A, Sikka Robby S (2014) Patient-specific instrumentation and return to activities after unicondylar knee arthroplasty. Clin Sports Med 33(1):133–148
Bradbury N, Borton D, Spoo G, Cross MJ (1998) Participation in sports after total knee replacement. Am J Sports Med 26(4):530–535
Cartier P, Sanouiller JL, Grelsamer RP (1996) Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 11:782
Chatterji U, Ashworth MJ, Lewis PL, Dobson PJ (2005) Effect of total knee arthroplasty on recreational and sporting activity. ANZ J Surg 75(6):405–408
Dahl AW, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S (2010) Unicompartmental knee arthroplasty in patients aged less than 65. Acta Orthop 81(1):90–94
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(1):118–122
Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplasty 18(7 Suppl 1):2–8
Fisher N, Agarwal M, Reuben SF, Johnson DS, Turner PG (2006) Sporting and physical activity following Oxford medial unicompartmental knee arthroplasty. Knee 13(4):296–300
Goodfellow JW, Kershaw CJ, Benson MK, O’Connor JJ (1998) The Oxford knee for unicompartmental osteoarthritis. The first 103 cases. J Bone Joint Surg [Br] 70:692–701
Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165
Huch K, Muller KA, Sturmer T, Brenner H, Puhl W, Gunther KP (2005) Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis 64(12):1715–1720
Jahromi I, Walton NP, Dobson PJ, Lewis PL, Campbell DG (2004) Patient-perceived outcome measures following unicompartmental knee arthroplasty with mini incision. Int Orthop 28(5):286–289
Kennedy WR, White RP (1987) Unicompartmental arthroplasty of the knee. Post-operative alignment and its influence on overall results. Clin Orthop Relat Res 221:278–285
Keys GW, Ul-Abiddin Z, Toh EM (2004) Analysis of first forty Oxford medial unicompartmental knee replacement from a small district hospital in UK. Knee 11(5):375–377
Kim KT, Lee S, Kim TW, Lee JS, Boo KH (2012) The influence of post-operative tibiofemoral alignment on the clinical results of unicompartmental knee arthroplasty. Knee Surg Relat Res 24(2):85–90
Kozinn SC, Scott R (1989) Current concepts review unicondylar knee arthroplasty. J Bone Joint Surg [Am] 71:145–150
Laubenthal KN (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52:34
McHorney CA, Ware JE, Rogers W, Raczek A, Lu JFR (1992) The validity and relative precision of MOS short- and long-form health status scales and Dartmouth COOP charts: results from the Medical Outcomes Study. Med Care 30(Suppl 15):MS253–MS265
Mullaji AB, Sharma A, Marawar S (2007) Unicompartmental knee arthroplasty: functional recovery and radiographic results with a minimally invasive technique. J Arthroplasty 22(4 Suppl 1):7–11
Naal FD, Fischer M, Preuss A, Goldhahn J, von Knoch F, Preiss S et al (2007) Return to sports and recreational activity after unicompartmental knee arthroplasty. Am J Sports Med 35(10):1688–1695
Pennington DW, Swienckowski JJ, Lutes WB, Drake GN (2003) Unicompartmental knee arthroplasty in patients 60 years of age or younger. J Bone Joint Surg [Am] 85:1968–1973
Rajasekhar C, Das S, Smith A (2004) Unicompartmental knee arthroplasty 2- to 12-year results in a community hospital. J Bone Joint Surg [Br] 86(7):983–985
Ridgeway SR, McAuley JP, Ammeen DJ, Engh GA (2002) The effect of alignment of the knee on the outcome of unicompartmental knee replacement. J Bone Joint Surg [Br] 84:351–355
Svard UC, Price AJ (2001) Oxford medial unicompartmental knee arthroplasty a survival analysis of an independent series. J Bone Joint Surg [Br] 83(2):191–194
Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19(2):112–116
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Seng, C.S., Ho, D.C., Chong, H.C. et al. Outcomes and survivorship of unicondylar knee arthroplasty in patients with severe deformity. Knee Surg Sports Traumatol Arthrosc 25, 639–644 (2017). https://doi.org/10.1007/s00167-014-3464-9
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DOI: https://doi.org/10.1007/s00167-014-3464-9