The Journal of Bone and Joint Surgery (American) 84:2235-2239 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Modern Unicompartmental Knee Arthroplasty with Cement
A Three to Ten-Year Follow-up Study
Jean-Noël A. Argenson, MD,
Yamina Chevrol-Benkeddache, MD and
Jean-Manuel Aubaniac, MD
Investigation performed at the Department of Orthopaedic Surgery, The Aix-Marseille University, Hôpital Sainte Marguerite, Marseille, France
Jean-Noël A. Argenson, MD
Yamina Chevrol-Benkeddache, MD
Jean-Manuel Aubaniac, MD
Department of Orthopaedic Surgery, The Aix-Marseille University, Hôpital Sainte Marguerite, 270 Boulevard de Sainte Marguerite, BP 29, 13274 Marseille CEDEX 09, France. E-mail address for J.-N.A. Argenson: jean-noel.argenson{at}ap_hm.fr
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).
Background: Unicompartmental arthroplasty is a treatment alternative when only one compartment of the knee is affected with arthritis, but the reported results of this procedure have been variable. The purpose of the present study was to evaluate the results of a modern unicompartmental knee arthroplasty performed with use of a cemented metal-backed prosthesis and surgical instrumentation comparable with that used for total knee replacement.
Methods: The indications for the procedure were osteonecrosis or osteoarthritis associated with full-thickness loss of cartilage that was limited to one tibiofemoral compartment as evaluated on standing and stress radiographs. One hundred and sixty consecutive cemented metal-backed Miller-Galante prostheses in 147 patients were evaluated after a mean duration of follow-up of sixty-six months (range, thirty-six to 112 months). The mean age of the patients at the time of the index procedure was sixty-six years.
Results: Three knees were revised because of progression of osteoarthritis in the patellofemoral joint (two knees) or the lateral tibiofemoral compartment (one knee). Two knees had revision of the polyethylene liner. The average Hospital for Special Surgery knee score improved from 59 points preoperatively to 96 points at the time of the review. According to Kaplan-Meier analysis, the ten-year survival rate (with twenty-nine knees at risk) was 94% ± 3% with revision for any reason or radiographic loosening as the end point.
Conclusions: A modern unicompartmental knee arthroplasty is a valid alternative for patients with unicompartmental tibiofemoral noninflammatory disease. The patient selection must be strict with regard to the status of the patellofemoral joint. The preoperative planning includes stress radiographs to assess the correction of the deformity and the status of the uninvolved compartment. Continued long-term follow-up is necessary to evaluate long-term polyethylene wear.
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