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Letters to the Editor to:

Scientific Articles:
Domenick J. Sisto and Isaac L. Mitchell
UniSpacer Arthroplasty of the Knee
J Bone Joint Surg Am 2005; 87: 1706-1711 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read Letter to the Editor] Dr. Sisto responds to Dr. Papavasileiou
Domenick J Sisto, M.D.   (25 October 2005)
[Read Letter to the Editor] Management of Failed UniSpacer Arthroplasty of the Knee
Athanasios V. PAPAVASILEIOU, BSc, M.D., Ph.D., Alex Chipperfield, MRCS, David Isaac, MRCS   (25 October 2005)

Dr. Sisto responds to Dr. Papavasileiou 25 October 2005
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Domenick J Sisto, M.D.,
Orthopaedic Surgeon
Los Angeles Orthopaedic Institute, Sherman Oaks, CA 91403

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Re: Dr. Sisto responds to Dr. Papavasileiou

laortho1{at}yahoo.com Domenick J Sisto, M.D.

I thank Dr. Papavasileiou for his letter.

The patients were ideal candidates to be revised to a unicompartmental arthroplasty following the failure of their Unispacer. I chose to perform a total knee arthroplasty because, in my hands, I can more reliably predict an excellent outcome with this procedure. I frequently perform unicompartmental arthroplasties but am still occasionally disappointed with their result and I must eventually perform a total knee arthroplasty a few years later. I felt that I had already subjected these patients to one failed procedure and I wanted to minimize the possibility of a second failure.

Sincerely,

Domenick J. Sisto, M.D.
Management of Failed UniSpacer Arthroplasty of the Knee 25 October 2005
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Athanasios V. PAPAVASILEIOU, BSc, M.D., Ph.D.,
Orthopaedic Surgeon
East Sussex Hospitals NHS Trust, Eastborne DGH, East Sussex, UK,
Alex Chipperfield, MRCS, David Isaac, MRCS

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Re: Management of Failed UniSpacer Arthroplasty of the Knee

PpvslA{at}aol.com Athanasios V. PAPAVASILEIOU, BSc, M.D., Ph.D., et al.

To the Editor:

We would like to congratulate Drs. Sisto and Mitchell for their interesting article (1). However we feel that clarification is necessary regarding the management of the 12 failed UniSpacer arthroplasties.

As described in great detail in the paper the patients that had undergone the procedure had isolated unicompartmental osteoarthritis clinically, radiologically and arthroscopically. We wonder why the failed implants were revised to a Total Knee rather than Unicompartmental Knee Arthoplasty (UKA) since the patients seem to be ideal candidates for it. Did the intra-operative findings reveal any changes that would make a UKA unsuitable?

Yours truly,

Dr A. Papavasileiou BSc, MD, PhD

Mr A. Chipperfield MRCS

Mr D. Isaac MRCS

Reference:

1. Sisto DJ, Mitchell IL. UniSpacer Arthroplasty of the Knee. J Bone Joint Surg Am. 2005;87:1706-1711