The Journal of Bone and Joint Surgery, Vol 63, Issue 4 536-544, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Unicondylar unicompartmental replacement for osteoarthritis of the knee
RD Scott and RF Santore
Unicompartmental knee replacement is an attractive concept that offers
several potential advantages over bicompartmental or tricompartmental
replacement, including preservation of bone stock, of the anterior and
posterior cruciate ligaments, of the patellofemoral joint, and of the
normal opposite compartment. Of our first 100 consecutive knees that had
unicompartmental arthroplasty for osteoarthritis and were followed for two
to six years (average, three and one-half years), eighty-eight were medial
and twelve were lateral replacements. The ages of the patients at the time
of operation ranged from forty-six to eighty-five years, with an average
age of seventy-one years. At follow-up, pain relief was good to excellent
in 92 per cent of the knees. The average amount of flexion was 114 degrees
(range, 90 to 140 degrees); one-half of the knees had at least 120 degrees
of flexion. The average flexion contracture was 1 degree. There were no
infections and no peroneal palsies. At the time of writing, three failures
had required revision. Radiolucent lines at the bone-cement interface were
present around 8 per cent of the femoral components and 27 per cent of the
tibial components. Two femoral components subsided in obese patients. There
was no tibial loosening in the series. The most common complications, per
anserinus bursitis, occurred in 12 per cent of the knees and was treated
satisfactorily by injection of local anesthetics and steroids. Surgical
technique must be precise to prevent subluxation of the tibia on the femur
due to either improper positioning of the components or too tight a fit
(too much pressure) between them. We view unicompartmental replacement as
an attractive alternative for the treatment of unicompartmental
osteoarthritis in elderly patients. However, we are strong advocates of
proximal tibial osteotomy for unicompartmental osteoarthritis associated
with a varus deformity in selected patients.
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