Lateral unicompartmental knee replacement for the treatment of arthritis progression after medial unicompartmental replacement

  • H. Pandit
  • F. Mancuso
  • C. Jenkins
  • W. F. M. Jackson
  • A. J. Price
  • C. A. F. Dodd
  • D. W. Murray
Knee

Abstract

Purpose

Lateral progression of arthritis following medial unicompartmental knee arthroplasty (UKA), although infrequent, is still the most common reason for revision surgery. Treatment options normally include conversion to total knee arthroplasty. An alternative strategy for some patients may be addition of a lateral UKA. We report the first results of staged bi-compartmental UKA (Bi-UKA) strategy.

Methods

We retrospectively selected from our UKA database patients who underwent a lateral UKA to treat a symptomatic lateral osteoarthritis progression after a medial UKA. The analysis included a clinical and radiological assessment of each patient.

Results

Twenty-five patients for a total of 27 knees of staged Bi-UKA were carried out in a single centre. The mean time interval between primary medial UKA and the subsequent lateral UKA was 8.1 years (SD ± 4.6 years). The mean age at the time of the Bi-UKA was 77.1 years (SD ± 6.5 years). The median hospital stay was 3 (range 2–9 days) days, and the mean follow-up after Bi-UKA was 4 years (SD ± 1.9 years). The functional scores showed a significant improvement as compared to the pre-operative status (paired t test, p = 0.003). There were no radiological evidences of failure. None of the patients needed blood transfusion, and there was no significant complications related to the surgical procedure without further surgeries or revisions at final follow-up.

Conclusions

These results suggest that addition of a lateral UKA for arthritis progression following medial UKA is a good option in appropriately selected patients.

Level of evidence

Observational study without controls, Level IV.

Keywords

Arthroplasty Medial unicompartmental knee arthroplasty Lateral arthritis progression Staged bi-unicompartmental knee arthroplasty 

Notes

Acknowledgments

The authors would like to thank all those who assisted with the collection and processing of data, particularly Jo Brown, Barbara Marks and Jenny Ferris.

Compliance with ethical standards

Conflict of interest

The author or one or more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution or other non-profit organisation with which one or more of the authors are associated.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • H. Pandit
    • 1
  • F. Mancuso
    • 1
    • 2
  • C. Jenkins
    • 1
  • W. F. M. Jackson
    • 1
  • A. J. Price
    • 1
  • C. A. F. Dodd
    • 1
  • D. W. Murray
    • 1
  1. 1.Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)University of OxfordOxfordUK
  2. 2.Orthopaedics and Traumatology Unit“Santa Maria della Misericordia” University HospitalUdineItaly

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