Early effects of fixed bearing unicompartmental knee arthroplasty for lateral unicompartment osteoarthritis

doi:10.3877/cma.j.issn.1674-134X.2018.06.020

Abstract

Abstract:

Objective

To investigate surgical techniques and the early effects of fixed bearing lateral unicompartmental knee arthroplasty in treatment of isolated lateral tibiofemoral osteoarthritis.

Methods

Eleven cases of osteoarthritis were followed up including five males and six females. Inclusion criteria: lateral unicompartmental osteoarthritis; without extra knee deformity; integrity of anterior and posterior cruciate ligaments and medial and lateral collateral ligaments. The average age was (57±6)years and body mass index(BMI)was(29.5±2.7). Every case adopted weight-bearing X-ray, skyline patellofemoral radiographs and full-length lower limbs X-ray before the surgery. Surgical technique : standard parapatellar approach was used, the lateral compartment was cleaned up. The tibial cut was located by outside the medullary to make vertical and horizontal osteotomy. The cartilage of femoral part was removed, the prosthesis was installed with bone cement. Evaluation of the treatment was performed by Oxford knee score (OKS)and Knee Society score (KSS). Statistical analysis was done with Mann-Whitney U test.

Results

All the cases were followed up for (5.0±1.1)months.The OKS and KSS scores improved significantly after the surgery(OKS: Z=-11.345, KSS: Z=-15.542; both P<0.05). No complication was found at the end of follow-up.

Conclusion

The treatment of fixed bearing lateral unicompartmental knee arthroplasty is effective, which can preserve the ligament of the knee, reduce bone mass of osteotomy, and the knee function is good.

Key words: Arthroplasty, replacement, knee, Osteoarthritis, Orthopedic procedures

Yang Yang, Bing Wang, Zheming Bao, Haining Sun. Early effects of fixed bearing unicompartmental knee arthroplasty for lateral unicompartment osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(06): 857-862.

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References 28

[1]	Ahlbäck S. Osteoarthrosis of the knee: a radiographic investigation[J]. Acta Radiol Diagn, 1968, 277(277)：7-72.
[2]	Argenson JN A, Parratte S, Bertani A , et al. Long-term results with a lateral unicondylar replacement[J]. Clin Orthop Relat Res, 2008, 466(11)：2686-2693.
[3]	Argenson JN, Parratte S, Bertani A, et al. The new arthriticpatient and arthroplasty treatment options[J]. Bone Joint Surg Am, 2009, 91(5): 43-48.
[4]	Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern unicompartmental knee arthroplasty with cement：a threeto ten-year follow-up study[J]. Bone Joint Surg Am, 2002, 84(12): 2235-2239.
[5]	Kosashvili Y, Gross AE, Zywiel MG, et al. Total knee arthroplasty after failed distal femoral varus osteotomy using selectively stemmed posterior stabilized components[J]. Arthroplasty, 2011, 26(5): 738-743.
[6]	Skolnick MD, Bryan RS, Peterson LF. Unicompartmental polycentric knee arthroplasty: description and preliminary results.[J]. Clinical Orthopaedics & Related Research, 1975, 112(112)：208.
[7]	Marmor, Leonard. Lateral compartment arthroplasty of the knee[J]. Clin Orthop Relat Res, 1984，186(186)：115-121.
[8]	Engh GA. Orthopaedic crossfire-can we justify unicondylar arthroplasty as a temporizing procedure? in the affirmative[J]. Arthroplasty, 2002, 17(4 Suppl 1): 54-55.
[9]	Rougraff BT, Heck DA, Gibson AE. A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis[J]. Clin Orthop Relat Res, 1991, 273(273)：157.
[10]	Knutson K, Lindstrand A, Lidgren L. Survival of knee arthroplasties.A nation-wide multicentre investigation of 8000 cases[J]. Bone Joint Surg Br, 1986, 68(5): 795-803.
[11]	Sah AP, Scott RD. Lateral unicompartmental knee arthroplasty through a medial approach-Study with an average five-year follow-up[J]. Bone Joint Surg Am, 2007, 89A(9): 1948-1954.
[12]	Robertsson O, Borgquist L, Knutson K, et al. Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a costeffective alternative.15，437 primary tricompartmental prostheses were compared with 10，624 primary medial or lateral unicompartmental prostheses[J]. Acta Orthop Scand, 1999, 70(2): 170-175.
[13]	Pennington DW, Swienckowski JJ, Lutes WB, et al. Lateral unicompartmental knee arthroplasty-survivorship and technical considerations at an average follow-up of 12.4 years[J]. J Arthroplasty, 2006, 21(1): 13-17.
[14]	Ahlback S, Bauer GC, Bohne WH. Spontaneous osteonecrosis of the knee[J]. Arthritis Rheum, 1968, 11(6): 705-733.
[15]	Ashraf T, Newman JH, Evans RL, et al. Lateral unicompartmental knee replacement-Survivorship and clinical experience over 21[J]. Bone Joint Surg Br, 2002, 84B(8): 1126-1130.
[16]	Gibson PH, Goodfellow JW. Stress radiography in degenerative arthritis of the knee[J]. Bone Joint Surg Br, 1986, 68(4): 608-609.
[17]	Ohdera T, Tokunaga J. Kobayashi a unicompartmental knee arthroplasty for lateral gonarthrosis：midterm results[J]. Arthroplasty, 2001, 16(2): 196-200.
[18]	Hauptmann SM, Kreul U, Mazoochian F, et al. Influence of patellofemoral osteoarthritis on functional outcome after unicondylar knee arthroplasty[J]. Orthopade, 2005, 34(11)：1088, 1090-1093.
[19]	Beard DJ, Pandit H, Gill HS, et al. The influence of the presence and severity of preexisting patellofemoral degenerative changes on the outcome of the Oxford medial unicompartmental knee replacement[J]. Bone Joint Surg Br, 2007, 89(12): 1597-1601.
[20]	Beard DJ, Pandit H, Ostlere S, et al. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome[J]. Bone Joint Surg Br, 2007, 89(12): 1602-1607.
[21]	Moller JT, Weeth RE, Keller JO. Unicompartmental arthroplasty of the knee.Cadaver study of the importance of the anterior cruciate ligament[J]. Acta Orthop Scand, 1985, 56(2): 120-123.
[22]	Gunther T, Murray D, Miller R. Lateral unicompartmental arthroplasty with the Oxford meniscal knee[J]. Knee, 1996, 3(1－2)：0-39.
[23]	Argenson JN, Komistek RD, Aubaniac JM, et al. In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty[J]. Arthroplasty, 2002, 17(8): 1049-1054.
[24]	Komistek RD, Dennis DA, Mahfouz M. In vivo fluoroscopic analysis of the normal human knee[J]. Clin Orthop Relat Res, 2003, 410(410)：69-81.
[25]	Ollivier M, Abdel MP, Sébastien Parratte, et al. Lateral unicondylar knee arthroplasty (UKA): contemporary indications, surgical technique, and results[J]. Int Orthop, 2013, 38(2): 449-455.
[26]	Smith JRA, Robinson JR, Porteous AJ, et al. Fixed bearing lateral unicompartmental knee arthroplasty—short to midterm survivorship and knee scores for 101 prostheses[J]. Knee, 2014, 21(4)：843-847.
[27]	Argenson JN, Jean-noël A, Chevrol-Benkeddache Y, et al. Lateral unicompartmental knee arthroplasty[J]. Tech Knee Surg, 2005, 4(2)：79-88.
[28]	Gleeson RE, Evans R, Ackroyd CE, et al. Fixed or mobile bearing unicompartmental knee replacement? A comparative short study[J]. Knee, 2004, 11(5)：379-384.

?	OKS评分	KSS评分
术前	48.5±3.9	53.5±7.8
术后6月	20.0±2.9	89.4±4.2
Z值	－11.345	－15.542
P值	<0.01	<0.01

?	OKS评分	KSS评分
术前	48.5±3.9	53.5±7.8
术后6月	20.0±2.9	89.4±4.2
Z值	－11.345	－15.542
P值	<0.01	<0.01

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