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Comparative Study
. 2008 Nov;466(11):2686-93.
doi: 10.1007/s11999-008-0351-z. Epub 2008 Jun 24.

Long-term Results With a Lateral Unicondylar Replacement

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Free PMC article
Comparative Study

Long-term Results With a Lateral Unicondylar Replacement

Jean-Noël A Argenson et al. Clin Orthop Relat Res. .
Free PMC article

Abstract

While the literature suggests lateral unicondylar knee arthroplasty (UKA) improves function in the short- and medium-term, it is less clear on longer-term function. We asked (1) whether lateral UKA improved longer-term Knee Society scores and return to previous activity level); (2) whether there were any concerning longer-term radiographic findings (the Knee Society roentgenographic evaluation and scoring system); and (3) whether lateral UKA was durable as measured by survivorship to revision at 10 and 16 years. We retrospectively reviewed 39 patients with 40 lateral cemented metal-backed UKA. The patients had a mean age of 61 years at surgery. The etiologies were primary osteoarthritis in 24 knees, posttraumatic in 12 cases, and osteonecrosis in four cases. We performed clinical and radiographic evaluations at a minimum followup of 3 years (mean, 12.6 years; range, 3-23 years). Prostheses survivorship was 92% at 10 years and 84% at 16 years. Despite the limited number of indications and technical considerations, our data suggest lateral UKA is a reasonable alternative for isolated lateral femorotibial compartment disease.

Level of evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Figures

Fig. 1
Fig. 1
This anteroposterior radiograph of the knee shows asymptomatic osteoarthritis progression in the medial compartment.
Fig. 2
Fig. 2
A Kaplan-Meier survivorship analysis curve with revision for any reason as the endpoint is shown. The 10-year survivorship was 92% (95% confidence interval, 0.79–0.99) and the 16-year survivorship was 84% (95% confidence interval, 0.71–0.97).
Fig. 3
Fig. 3
Kaplan-Meier survivorship using revision as an endpoint in the group of patients operated on before 1989 and for the patients operated on after 1989 are shown. The log rank test demonstrated a difference in survivorship between the two groups (p = 0.007).
Fig. 4A–B
Fig. 4A–B
These radiographs show a well-functioning lateral unicondylar knee arthroplasty 23 years after implantation from (A) the anteroposterior view and (B) the mediolateral view.

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