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Patient Criteria for Unicompartmental Knee Arthroplasty: Are There Exclusion Criteria?

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Unicompartmental Knee Arthroplasty

Abstract

With an increased focus on minimally invasive surgery, rapid postoperative recovery and mimicking of native knee kinematics, unicondylar knee arthroplasty has recently gained in popularity. While contraindications to this surgery have classically been defined, recent studies have raised the possibility of expanding surgical indications. This chapter will identify recent controversies in indications for unicondylar knee arthroplasty, and it will review recent data suggesting that historical indications be revisited.

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References

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

    Article  CAS  PubMed  Google Scholar 

  2. Smith & Nephew Journey 2 UNI Surgical Technique Guide. 2015. https://www.smith-nephew.com/documents/nl-journey-uni-surgicaltechnique.pdf.

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

    PubMed  Google Scholar 

  4. Faour Martín O, Valverde García JA, Martín Ferrero MÁ, Vega Castrillo A, Zuil Acosta P, Suárez De Puga CC. The young patient and the medial unicompartmental knee replacement. Acta Orthop Belg. 2015;81:283–8.

    PubMed  Google Scholar 

  5. Walker T, Streit J, Gotterbarm T, Bruckner T, Merle C, Streit MR. Sports, physical activity and patient-reported outcomes after medial Unicompartmental knee arthroplasty in young patients. J Arthroplast. 2015;30:1911–6. https://doi.org/10.1016/j.arth.2015.05.031.

    Article  Google Scholar 

  6. Streit MR, Streit J, Walker T, Bruckner T, Philippe Kretzer J, Ewerbeck V, et al. Minimally invasive Oxford medial unicompartmental knee arthroplasty in young patients. Knee Surg Sports Traumatol Arthrosc. 2017;25:660–8. https://doi.org/10.1007/s00167-015-3620-x.

    Article  PubMed  Google Scholar 

  7. Kandil A, Werner BC, Gwathmey WF, Browne JA. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplast. 2015;30:456–60. https://doi.org/10.1016/j.arth.2014.10.016.

    Article  Google Scholar 

  8. Molloy J, Kennedy J, Jenkins C, Mellon S, Dodd C, Murray D. Obesity should not be considered a contraindication to medial Oxford UKA: long-term patient-reported outcomes and implant survival in 1000 knees. Knee Surg Sports Traumatol Arthrosc. 2018;27:2259. https://doi.org/10.1007/s00167-018-5218-6.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Plate JF, Augart MA, Seyler TM, Bracey DN, Hoggard A, Akbar M, et al. Obesity has no effect on outcomes following unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25:645–51. https://doi.org/10.1007/s00167-015-3597-5.

    Article  PubMed  Google Scholar 

  10. van der List JP, Chawla H, Zuiderbaan HA, Pearle AD. The role of preoperative patient characteristics on outcomes of unicompartmental knee arthroplasty: a meta-analysis critique. J Arthroplast. 2016;31:2617–27. https://doi.org/10.1016/j.arth.2016.04.001.

    Article  Google Scholar 

  11. Hernigou P, Deschamps G. Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2004;423:161–5.

    Article  Google Scholar 

  12. Chatellard R, Sauleau V, Colmar M, Robert H, Raynaud G, Brilhault J. Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res. 2013;99:S219–25. https://doi.org/10.1016/j.otsr.2013.03.004.

    Article  CAS  PubMed  Google Scholar 

  13. Deshmukh RV, Scott RD. Unicompartmental knee arthroplasty: long-term results. Clin Orthop Relat Res. 2001;392:272–8.

    Article  Google Scholar 

  14. Scott RD. Unicondylar arthroplasty: redefining itself. Orthopedics. 2003;26:951–2.

    PubMed  Google Scholar 

  15. Gulati A, Pandit H, Jenkins C, Chau R, Dodd CA, Murray DW. The effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br. 2009;91:469–74. https://doi.org/10.1302/0301-620X.91B4.22105.

    Article  CAS  PubMed  Google Scholar 

  16. Kleeblad LJ, van der List JP, Pearle AD, Fragomen AT, Rozbruch SR. Predicting the feasibility of correcting mechanical axis in large varus deformities with unicompartmental knee arthroplasty. J Arthroplast. 2018;33:372–8. https://doi.org/10.1016/j.arth.2017.09.052.

    Article  Google Scholar 

  17. Ollivier M, Abdel MP, Parratte S, Argenson J-N. Lateral unicondylar knee arthroplasty (UKA): contemporary indications, surgical technique, and results. Int Orthop. 2014;38:449–55. https://doi.org/10.1007/s00264-013-2222-9.

    Article  PubMed  Google Scholar 

  18. Suero EM, Citak M, Cross MB, Bosscher MRF, Ranawat AS, Pearle AD. Effects of tibial slope changes in the stability of fixed bearing medial unicompartmental arthroplasty in anterior cruciate ligament deficient knees. Knee. 2012;19:365–9. https://doi.org/10.1016/j.knee.2011.07.004.

    Article  PubMed  Google Scholar 

  19. Engh GA, Ammeen DJ. Unicondylar arthroplasty in knees with deficient anterior cruciate ligaments. Clin Orthop Relat Res. 2014;472:73–7. https://doi.org/10.1007/s11999-013-2982-y.

    Article  PubMed  Google Scholar 

  20. Boissonneault A, Pandit H, Pegg E, Jenkins C, Gill HS, Dodd CAF, et al. No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2013;21:2480–6. https://doi.org/10.1007/s00167-012-2101-8.

    Article  PubMed  Google Scholar 

  21. Pandit H, Van Duren BH, Gallagher JA, Beard DJ, Gill HS DCA, et al. Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthroplasty: in vivo kinematics. Knee. 2008;15:101–6. https://doi.org/10.1016/j.knee.2007.11.008.

    Article  CAS  PubMed  Google Scholar 

  22. Tinius M, Hepp P, Becker R. Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2012;20:81–7. https://doi.org/10.1007/s00167-011-1528-7.

    Article  PubMed  Google Scholar 

  23. Konan S, Haddad FS. Does location of patellofemoral chondral lesion influence outcome after Oxford medial compartmental knee arthroplasty? Bone Joint J. 2016;98-B:11–5. https://doi.org/10.1302/0301-620X.98B10.BJJ-2016-0403.R1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Thein R, Zuiderbaan HA, Khamaisy S, Nawabi DH, Poultsides LA, Pearle AD. Medial unicondylar knee arthroplasty improves patellofemoral congruence: a possible mechanistic explanation for poor association between patellofemoral degeneration and clinical outcome. J Arthroplast. 2015;30:1917–22. https://doi.org/10.1016/j.arth.2015.05.034.

    Article  Google Scholar 

  25. Song M-H, Kim B-H, Ahn S-J, Yoo S-H, Kang S-W, Oh K-T. Does the appearance of the patellofemoral joint at surgery influence the clinical result in medial unicompartmental knee arthroplasty? Knee. 2013;20:457–60. https://doi.org/10.1016/j.knee.2013.05.005.

    Article  PubMed  Google Scholar 

  26. Song E-K, Park J-K, Park C-H, Kim M-C, Agrawal PR, Seon JK. No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2016;24:208–13. https://doi.org/10.1007/s00167-014-3367-9.

    Article  PubMed  Google Scholar 

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Correspondence to Jeffrey A. Geller .

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Neuwirth, A.L., Grosso, M.J., Geller, J.A. (2020). Patient Criteria for Unicompartmental Knee Arthroplasty: Are There Exclusion Criteria?. In: Gerlinger, T. (eds) Unicompartmental Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-27411-5_3

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  • DOI: https://doi.org/10.1007/978-3-030-27411-5_3

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