Advertisement

Medial Unicompartmental Knee Arthroplasty: Indications and Technique

  • Brian C. FullerEmail author
  • Tad L. Gerlinger
Chapter

Abstract

Medial unicompartmental knee arthroplasty is an excellent surgical option for the treatment of isolated medial compartment arthritis. Modern implants demonstrate outstanding function and survivorship. Additionally, the procedure is less demanding for both the surgeon and the patient. The potential for enhanced patient recovery utilizing straightforward surgical techniques and same-day surgery protocols has helped repopularize the procedure. Exceptional clinical results persist even as contemporary indications expand. Moreover, unicompartmental knee arthroplasty is associated with a lower occurrence of complications and mortality. The most common modes of failure for fixed-bearing medial unicompartmental knee arthroplasty are progression of adjacent compartment arthritis and aseptic loosening. Revision results closely approximate that of a revision total knee arthroplasty.

Keywords

Medial Unicompartmental Knee Arthroplasty Fixed bearing 

References

  1. 1.
    Marmor L. Results of single compartment arthroplasty with acrylic cement fixation. A minimum follow-up of two years. Clin Orthop Relat Res. 1977;122:181–8.Google Scholar
  2. 2.
    Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am. 1978;60(2):182–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980;62(8):1329–37.CrossRefPubMedGoogle Scholar
  4. 4.
    Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am. 1989;71(1):145–50.CrossRefPubMedGoogle Scholar
  5. 5.
    Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, et al. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res. 1999;367:50–60.CrossRefGoogle Scholar
  6. 6.
    Foran JRH, Brown NM, Della Valle CJ, Berger RA, Galante JO. Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2013;471(1):102–8.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Pandit H, Hamilton TW, Jenkins C, Mellon SJ, Dodd CAF, Murray DW. The clinical outcome of minimally invasive phase 3 Oxford unicompartmental knee arthroplasty: a 15-year follow-up of 1000 UKAs. Bone Joint J. 2015;97-B(11):1493–500.CrossRefPubMedGoogle Scholar
  8. 8.
    Bolognesi MP, Greiner MA, Attarian DE, Watters TS, Wellman SS, Curtis LH, et al. Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009. J Bone Joint Surg Am. 2013;95(22):e174.CrossRefPubMedGoogle Scholar
  9. 9.
    Sébilo A, Casin C, Lebel B, Rouvillain J-L, Chapuis S, Bonnevialle P, et al. Clinical and technical factors influencing outcomes of unicompartmental knee arthroplasty: retrospective multicentre study of 944 knees. Orthop Traumatol Surg Res. 2013;99(4 Suppl):S227–34.CrossRefPubMedGoogle Scholar
  10. 10.
    Xing Z, Katz J, Jiranek W. Unicompartmental knee arthroplasty: factors influencing the outcome. J Knee Surg. 2012;25(5):369–73.CrossRefPubMedGoogle Scholar
  11. 11.
    Carlos Rodríguez-Merchán E, Gómez-Cardero P. Unicompartmental knee arthroplasty: current indications, technical issues and results. EFORT Open Rev. 2018;3(6):363–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Cody JP, Pfefferle KJ, Ammeen DJ, Fricka KB. Is outpatient unicompartmental knee arthroplasty safe to perform at an ambulatory surgery center? A comparative study of early post-operative complications. J Arthroplast. 2018;33(3):673–6.CrossRefGoogle Scholar
  13. 13.
    Kort NP, Bemelmans YFL, Schotanus MGM. Outpatient surgery for unicompartmental knee arthroplasty is effective and safe. Knee Surg Sports Traumatol Arthrosc. 2017;25(9):2659–67.CrossRefPubMedGoogle Scholar
  14. 14.
    Cross MB, Berger R. Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop. 2014;38(2):443–7.CrossRefPubMedGoogle Scholar
  15. 15.
    White SH, Ludkowski PF, Goodfellow JW. Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br. 1991;73(4):582–6.CrossRefPubMedGoogle Scholar
  16. 16.
    Jennings JM, Kleeman-Forsthuber LT, Bolognesi MP. Medial unicompartmental arthroplasty of the knee. J Am Acad Orthop Surg [Internet]. 2018; Available from:  https://doi.org/10.5435/JAAOS-D-17-00690.
  17. 17.
    Chalmers BP, Mehrotra KG, Sierra RJ, Pagnano MW, Taunton MJ, Abdel MP. Reliable outcomes and survivorship of unicompartmental knee arthroplasty for isolated compartment osteonecrosis. Bone Joint J. 2018;100-B(4):450–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Berend KR, Berend ME, Dalury DF, Argenson J-N, Dodd CA, Scott RD. Consensus statement on indications and contraindications for medial unicompartmental knee arthroplasty. J Surg Orthop Adv. 2015;24(4):252–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Hamilton TW, Pandit HG, Jenkins C, Mellon SJ, Dodd CAF, Murray DW. Evidence-based indications for mobile-bearing unicompartmental knee arthroplasty in a consecutive cohort of thousand knees. J Arthroplast. 2017;32(6):1779–85.CrossRefGoogle Scholar
  20. 20.
    Richardson AB, Morris MJ. Medial unicompartmental knee arthroplasty. Instr Course Lect. 2017;66:201–9.PubMedGoogle Scholar
  21. 21.
    Iacono F, Raspugli GF, Akkawi I, Bruni D, Filardo G, Budeyri A, et al. Unicompartmental knee arthroplasty in patients over 75 years: a definitive solution? Arch Orthop Trauma Surg. 2016;136(1):117–23.CrossRefPubMedGoogle Scholar
  22. 22.
    Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ. Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplast. 2017;32(6):1792–7.CrossRefGoogle Scholar
  23. 23.
    Kennedy JA, Matharu GS, Hamilton TW, Mellon SJ, Murray DW. Age and outcomes of medial meniscal-bearing unicompartmental knee arthroplasty. J Arthroplast. 2018;33(10):3153–9.CrossRefGoogle Scholar
  24. 24.
    Heyse TJ, Khefacha A, Peersman G, Cartier P. Survivorship of UKA in the middle-aged. Knee. 2012;19(5):585–91.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Biswas D, Van Thiel GS, Wetters NG, Pack BJ, Berger RA, Della Valle CJ. Medial unicompartmental knee arthroplasty in patients less than 55 years old: minimum of two years of follow-up. J Arthroplast. 2014;29(1):101–5.CrossRefGoogle Scholar
  26. 26.
    Krych AJ, Reardon P, Sousa P, Pareek A, Stuart M, Pagnano M. Unicompartmental knee arthroplasty provides higher activity and durability than Valgus-producing proximal tibial osteotomy at 5 to 7 years. J Bone Joint Surg Am. 2017;99(2):113–22.CrossRefPubMedGoogle Scholar
  27. 27.
    Kim KT, Lee S, Lee JS, Kang MS, Koo KH. Long-term clinical results of unicompartmental knee arthroplasty in patients younger than 60 years of age: minimum 10-year follow-up. Knee Surg Relat Res. 2018;30(1):28–33.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Cavaignac E, Lafontan V, Reina N, Pailhé R, Wargny M, Laffosse JM, et al. Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013;95-B(8):1064–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Zengerink I, Duivenvoorden T, Niesten D, Verburg H, Bloem R, Mathijssen N. Obesity does not influence the outcome after unicompartmental knee arthroplasty. Acta Orthop Belg. 2015;81(4):776–83.PubMedGoogle Scholar
  30. 30.
    Woo YL, Chen YQJ, Lai MC, Tay KJD, Chia S-L, Lo NN, et al. Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty? J Orthop Surg. 2017;25(1):2309499016684297.CrossRefGoogle Scholar
  31. 31.
    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(3):645–51.CrossRefPubMedGoogle Scholar
  32. 32.
    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(1):208–13.CrossRefPubMedGoogle Scholar
  33. 33.
    Adams AJ, Kazarian GS, Lonner JH. Preoperative patellofemoral chondromalacia is not a contraindication for fixed-bearing medial unicompartmental knee arthroplasty. J Arthroplast. 2017;32(6):1786–91.CrossRefGoogle Scholar
  34. 34.
    Hamilton TW, Choudhary R, Jenkins C, Mellon SJ, Dodd CAF, Murray DW, et al. Lateral osteophytes do not represent a contraindication to medial unicompartmental knee arthroplasty: a 15-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2017;25(3):652–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Hernigou P, Deschamps G. Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am. 2004;86-A(3):506–11.CrossRefGoogle Scholar
  36. 36.
    Engh GA, Ammeen DJ. Unicondylar arthroplasty in knees with deficient anterior cruciate ligaments. Clin Orthop Relat Res. 2014;472(1):73–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Pandit H, Beard DJ, Jenkins C, Kimstra Y, Thomas NP, Dodd CAF, et al. Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthroplasty. J Bone Joint Surg Br. 2006;88(7):887–92.CrossRefPubMedGoogle Scholar
  38. 38.
    Ventura A, Legnani C, Terzaghi C, Iori S, Borgo E. Medial unicondylar knee arthroplasty combined to anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2017;25(3):675–80.CrossRefPubMedGoogle Scholar
  39. 39.
    Mallory TH, Danyi J. Unicompartmental total knee arthroplasty. A five- to nine-year follow-up study of 42 procedures. Clin Orthop Relat Res. 1983;175:135–8.Google Scholar
  40. 40.
    Whittaker J-P, Naudie DDR, 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.CrossRefPubMedGoogle Scholar
  41. 41.
    Parratte S, Pauly V, Aubaniac J-M, Argenson J-NA. No long-term difference between fixed and mobile medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2012;470(1):61–8.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P. Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3296–305.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Neufeld ME, Albers A, Greidanus NV, Garbuz DS, Masri BA. A comparison of mobile and fixed-bearing unicompartmental knee arthroplasty at a minimum 10-year follow-up. J Arthroplast. 2018;33(6):1713–8.CrossRefGoogle Scholar
  44. 44.
    Ozcan C, Simsek ME, Tahta M, Akkaya M, Gursoy S, Bozkurt M. Fixed-bearing unicompartmental knee arthroplasty tolerates higher variance in tibial implant rotation than mobile-bearing designs. Arch Orthop Trauma Surg. 2018;138(10):1463–9.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Forster-Horváth C, Artz N, Hassaballa MA, Robinson JR, Porteous AJ, Murray JR, et al. Survivorship and clinical outcome of the minimally invasive Uniglide medial fixed bearing, all-polyethylene tibia, unicompartmental knee arthroplasty at a mean follow-up of 7.3years. Knee. 2016;23(6):981–6.CrossRefPubMedGoogle Scholar
  46. 46.
    Hawi N, Plutat J, Kendoff D, Suero EM, Cross MB, Gehrke T, et al. Midterm results after unicompartmental knee replacement with all-polyethylene tibial component: a single surgeon experience. Arch Orthop Trauma Surg. 2016;136(9):1303–7.CrossRefPubMedGoogle Scholar
  47. 47.
    Rouanet T, Combes A, Migaud H, Pasquier G. Do bone loss and reconstruction procedures differ at revision of cemented unicompartmental knee prostheses according to the use of metal-back or all-polyethylene tibial component? Orthop Traumatol Surg Res. 2013;99(6):687–92.CrossRefPubMedGoogle Scholar
  48. 48.
    Hutt JRB, Farhadnia P, Massé V, LaVigne M, Vendittoli P-A. A randomised trial of all-polyethylene and metal-backed tibial components in unicompartmental arthroplasty of the knee. Bone Joint J. 2015;97-B(6):786–92.CrossRefPubMedGoogle Scholar
  49. 49.
    Koh IJ, Suhl KH, Kim MW, Kim MS, Choi KY, In Y. Use of all-polyethylene tibial components in unicompartmental knee arthroplasty increases the risk of early failure. J Knee Surg. 2017;30(8):807–15.CrossRefPubMedGoogle Scholar
  50. 50.
    van der List JP, Kleeblad LJ, Zuiderbaan HA, Pearle AD. Mid-term outcomes of metal-backed unicompartmental knee arthroplasty show superiority to all-polyethylene unicompartmental and total knee arthroplasty. HSS J. 2017;13(3):232–40.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Scott CEH, Wade FA, MacDonald D, Nutton RW. Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component. Arch Orthop Trauma Surg. 2018;138(5):719–29.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Small SR, Berend ME, Ritter MA, Buckley CA, Rogge RD. Metal backing significantly decreases tibial strains in a medial unicompartmental knee arthroplasty model. J Arthroplast. 2011;26(5):777–82.CrossRefGoogle Scholar
  53. 53.
    Scott CEH, Eaton MJ, Nutton RW, Wade FA, Evans SL, Pankaj P. Metal-backed versus all-polyethylene unicompartmental knee arthroplasty: proximal tibial strain in an experimentally validated finite element model. Bone Joint Res. 2017;6(1):22–30.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    van der List JP, Sheng DL, Kleeblad LJ, Chawla H, Pearle AD. Outcomes of cementless unicompartmental and total knee arthroplasty: a systematic review. Knee. 2017;24(3):497–507.CrossRefPubMedGoogle Scholar
  55. 55.
    Campi S, Pandit HG, Dodd CAF, Murray DW. Cementless fixation in medial unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017;25(3):736–45.CrossRefPubMedGoogle Scholar
  56. 56.
    Ollivier M, Parratte S, Lunebourg A, Viehweger E, Argenson J-N. The John Insall award: no functional benefit after unicompartmental knee arthroplasty performed with patient-specific instrumentation: a randomized trial. Clin Orthop Relat Res. 2016;474(1):60–8.CrossRefPubMedGoogle Scholar
  57. 57.
    Alvand A, Khan T, Jenkins C, Rees JL, Jackson WF, Dodd CAF, et al. The impact of patient-specific instrumentation on unicompartmental knee arthroplasty: a prospective randomised controlled study. Knee Surg Sports Traumatol Arthrosc. 2018;26(6):1662–70.CrossRefPubMedGoogle Scholar
  58. 58.
    Lonner JH, Klement MR. Robotic-assisted medial unicompartmental knee arthroplasty: options and outcomes. J Am Acad Orthop Surg [Internet]. 2018; Available from:  https://doi.org/10.5435/JAAOS-D-17-00710.
  59. 59.
    Fu J, Wang Y, Li X, Yu B, Ni M, Chai W, et al. Robot-assisted vs. conventional unicompartmental knee arthroplasty: systematic review and meta-analysis. Orthopade [Internet]. 2018; Available from:  https://doi.org/10.1007/s00132-018-3604-x.
  60. 60.
    Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW. Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res. 2012;470(1):84–90.CrossRefPubMedGoogle Scholar
  61. 61.
    Horikawa A, Miyakoshi N, Shimada Y, Kodama H. Comparison of clinical outcomes between total knee arthroplasty and unicompartmental knee arthroplasty for osteoarthritis of the knee: a retrospective analysis of preoperative and postoperative results. J Orthop Surg Res. 2015;10:168.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and total knee arthroplasties: a propensity score-matched analysis. J Arthroplast. 2017;32(5):1453–9.CrossRefGoogle Scholar
  63. 63.
    Burn E, Sanchez-Santos MT, Pandit HG, Hamilton TW, Liddle AD, Murray DW, et al. Ten-year patient-reported outcomes following total and minimally invasive unicompartmental knee arthroplasty: a propensity score-matched cohort analysis. Knee Surg Sports Traumatol Arthrosc. 2018;26(5):1455–64.CrossRefPubMedGoogle Scholar
  64. 64.
    Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, et al. Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplast. 2012;27(8 Suppl):86–90.CrossRefGoogle Scholar
  65. 65.
    Liddle AD, Judge A, Pandit H, Murray DW. Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet. 2014;384(9952):1437–45.CrossRefPubMedGoogle Scholar
  66. 66.
    Burn E, Liddle AD, Hamilton TW, Pai S, Pandit HG, Murray DW, et al. Choosing between unicompartmental and total knee replacement: what can economic evaluations tell us? A systematic review. Pharmacoecon Open. 2017;1(4):241–53.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Vasso M, Del Regno C, Perisano C, D’Amelio A, Corona K, Schiavone PA. Unicompartmental knee arthroplasty is effective: ten year results. Int Orthop. 2015;39(12):2341–6.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Winnock de Grave P, Barbier J, Luyckx T, Ryckaert A, Gunst P, Van den Daelen L. Outcomes of a fixed-bearing, medial, cemented unicondylar knee arthroplasty design: survival analysis and functional score of 460 cases. J Arthroplast. 2018;33(9):2792–9.CrossRefGoogle Scholar
  69. 69.
    van der List JP, McDonald LS, Pearle AD. Systematic review of medial versus lateral survivorship in unicompartmental knee arthroplasty. Knee. 2015;22(6):454–60.CrossRefPubMedGoogle Scholar
  70. 70.
    Liddle AD, Pandit H, Judge A, Murray DW. Effect of surgical caseload on revision rate following total and unicompartmental knee replacement. J Bone Joint Surg Am. 2016;98(1):1–8.CrossRefPubMedGoogle Scholar
  71. 71.
    van der List JP, Zuiderbaan HA, Pearle AD. Why do medial unicompartmental knee arthroplasties fail today? J Arthroplast. 2016;31(5):1016–21.CrossRefGoogle Scholar
  72. 72.
    Vasso M, Corona K, D’Apolito R, Mazzitelli G, Panni AS. Unicompartmental knee arthroplasty: modes of failure and conversion to total knee arthroplasty. Joints. 2017;5(1):44–50.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA. Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplast. 2006;21(6 Suppl 2):108–15.CrossRefGoogle Scholar
  74. 74.
    Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone PA. Minor varus alignment provides better results than neutral alignment in medial UKA. Knee. 2015;22(2):117–21.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Järvenpää J, Kettunen J, Miettinen H, Kröger H. The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8-17 years follow-up study of 49 patients. Int Orthop. 2010;34(5):649–53.CrossRefPubMedGoogle Scholar
  76. 76.
    Craik JD, El Shafie SA, Singh VK, Twyman RS. Revision of unicompartmental knee arthroplasty versus primary total knee arthroplasty. J Arthroplast. 2015;30(4):592–4.CrossRefGoogle Scholar
  77. 77.
    Leta TH, Lygre SHL, Skredderstuen A, Hallan G, Gjertsen J-E, Rokne B, et al. Outcomes of unicompartmental knee arthroplasty after aseptic revision to total knee arthroplasty: a comparative study of 768 TKAs and 578 UKAs revised to TKAs from the Norwegian Arthroplasty register (1994 to 2011). JBJS. 2016;98(6):431–40.CrossRefGoogle Scholar
  78. 78.
    Sun X, Su Z. A meta-analysis of unicompartmental knee arthroplasty revised to total knee arthroplasty versus primary total knee arthroplasty. J Orthop Surg Res. 2018;13(1):158.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Lee JK, Kim HJ, Park JO, Yang J-H. Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3403–18.CrossRefPubMedGoogle Scholar
  80. 80.
    Crawford DA, Berend KR, Lombardi AV. Management of the failed medial unicompartmental knee arthroplasty. J Am Acad Orthop Surg. 2018;26(20):e426–33.CrossRefPubMedGoogle Scholar
  81. 81.
    Lunebourg A, Parratte S, Galland A, Lecuire F, Ollivier M, Argenson J-N. Is isolated insert exchange a valuable choice for polyethylene wear in metal-backed unicompartmental knee arthroplasty? Knee Surg Sports Traumatol Arthrosc. 2016;24(10):3280–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Adult Reconstruction Division, Department of Orthopaedic SurgeryRush University Medical CenterChicagoUSA

Personalised recommendations