Reliable outcomes and survivorship of unicompartmental knee arthroplasty for isolated compartment osteonecrosis

Abstract

When done for primary osteonecrosis of the knee, UKA resulted in reliable clinical improvement, minimal complications, and durable estimated implant survivorship free of revision at ten years. UKA done for secondary osteonecrosis was substantially less durable at mid-term follow-up. Progression of knee degeneration, rather than implant failure or loosening, was most common indication for conversion to TKA. Cite this article: Bone Joint J 2018;100-B:450-4.

Lateral Unicompartmental knee arthroplasty for a secondary osteonecrosis of the lateral femoral condyle. A case report

“…Although the patient felt significant pain relief and achieved satisfactory knee joint function, it is essential to avoid excessive knee flexion, squat and intense activities in the early period after surgery. Similarly, B. P. Chalmers et al [6] analyzed outcomes of 46 UKAs for osteonecrosis involving an isolated compartment of the knee and found Survivorship free of any revision in the cohort was 89% (95% CI 77 to 99) and 76% (95% CI 53 to 99) at five and ten years, respectively. No implants were revised for loosening, fracture, or wear.…”

“…Unicompartmental knee arthroplasty (UKA) is considered one of the most effective treatments for knee osteonecrosis relive pain and maintain native knee kinematics [4][5][6][7]. Advantages of UKA include faster recovery, better functional outcomes, better preservation of the joint and saving of bone tissue [8,9].…”

Actual analysis of complications after unicompartmental arthroplasty of the knee joint

“…Основними причинами виконання тотального ендопротезування після монокондилярного, на думку Sierra et al, є нестабільність компонентів ендопротеза (55%) та прогресування остеоартрозу (34%) [9]. Bergeson et al дійшли висновку, що прогресування остеоартрозу асоційоване зі зношуванням поліетиленової вкладки.…”

Robotic-arm assisted medial unicondylar knee arthroplasty versus jig-based unicompartmental knee arthroplasty with navigation control: study protocol for a prospective randomised controlled trial

“…There are several advantages of performing UKA over total knee arthroplasty (TKA), including reduced operating time, decreased intraoperative blood loss, reduced periarticular soft tissue trauma, improved preservation of bone stock, better restoration of native kinematics, increased patient satisfaction, and improved functional outcomes [ 7 , 16 , 20 , 21 , 34 , 35 ]. However, UKA is associated with decreased implant survivorship and increased revision rates compared with TKA [ 9 , 28 ]. Accuracy of component positioning and limb alignment are important prognostic variables that affect implant survival and time to revision surgery following UKA [ 5 , 9 , 38 ].…”

“…However, UKA is associated with decreased implant survivorship and increased revision rates compared with TKA [ 9 , 28 ]. Accuracy of component positioning and limb alignment are important prognostic variables that affect implant survival and time to revision surgery following UKA [ 5 , 9 , 38 ]. Consequently, techniques that improve the accuracy of implant positioning and limb alignment in UKA may help to improve long-term survivorship and reduce the burden of revision disease.…”