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Lateral Unicompartmental Knee Replacement Surgery for Lateral Knee Osteoarthritis

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Surgical Management of Knee Arthritis

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Abstract

Isolated lateral knee osteoarthritis accounts for 5% of symptomatic knee osteoarthritis (OA) cases. Given the unique anatomy and resulting kinematics of the lateral compartment of the knee, the surgical technique, indications, and strategies previously developed for Unicompartmental Knee Replacement (UKR) of the medial compartment, are not directly applicable to the lateral UKR (LUKR).

A better understanding of patient selection, refined implant designs, precise surgical procedure, and increasing surgeon experience over time have led to improved functional outcomes, high implant survival, and ultimately greater confidence in this treatment option. Today, LUKR is an established treatment for isolated lateral knee OA. UKR has many benefits over total knee replacement (TKR), including better functional outcomes, shorter hospital stays, lower mortality, and lower early reoperation rates for any reason. Despite strong evidence in the literature of better outcomes with UKR than TKR, UKR is not as popular as TKR, and specifically LUKR, remains hindered by the perceived technical difficulty owing to the need for accurate ligament balancing of the procedure and naturally lower disease prevalence leading to fewer operations.

LUKR implants feature either a fixed bearing or a mobile bearing. This chapter provides a comprehensive overview of implants available for LUKR reported in the literature and registries, summarising the functional outcomes, implant survival, and the main complications.

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Authors and Affiliations

  1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

    Irene Yang

  2. Leeds Orthopaedic Trauma Sciences, Leeds Institute of Rheumatology and Musculoskeletal Medicine, University of Leeds, Leeds, UK

    Bernard H. van Duren & Hemant G. Pandit

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  3. Hemant G. Pandit
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Correspondence to Hemant G. Pandit .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Hospital For Joint Diseases, New York, NY, USA

    Ajit J. Deshmukh

  2. University Clinical Center of Kosovo, Pristina, Kosovo

    Bujar H. Shabani

  3. Orthopedic Clinic Paulinenhilfe, Diakonie Klinikum, Stuttgart, Germany

    Wenzel Waldstein

  4. Department of Orthopedic Surgery, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA

    Julius K. Oni

Appendices

Appendix A: Demographic Information for Studies

See Table 21.4.

Table 21.4 Demographic information of LUKR studies
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Appendix B: Registry Information

See Table 21.5.

Table 21.5 Arthroplasty registries from around the world based on those listed in Hughes et al. [128]
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Appendix C: Excluded Registry Listed Implants

See Table 21.6.

Table 21.6 Implants listed as UKR implants, but excluded from summary list
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Yang, I., van Duren, B.H., Pandit, H.G. (2023). Lateral Unicompartmental Knee Replacement Surgery for Lateral Knee Osteoarthritis. In: Deshmukh, A.J., Shabani, B.H., Waldstein, W., Oni, J.K. (eds) Surgical Management of Knee Arthritis. Springer, Cham. https://doi.org/10.1007/978-3-031-47929-8_21

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