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Comparative Study
. 2012 Jan;470(1):77-83.
doi: 10.1007/s11999-011-2005-9.

Lateral Unicompartmental Knee Arthroplasty Through a Lateral Parapatellar Approach Has High Early Survivorship

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Free PMC article
Comparative Study

Lateral Unicompartmental Knee Arthroplasty Through a Lateral Parapatellar Approach Has High Early Survivorship

Keith R Berend et al. Clin Orthop Relat Res. .
Free PMC article

Abstract

Background: The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthroplasty.

Questions/purposes: We report our indications for lateral unicompartmental arthroplasty, how we perform this procedure, and the subsequent Knee Society scores, ROM, and revision and reoperation rates.

Patients and methods: From a retrospective review of electronic records from 2004 through 2008, we identified 93 patients who had 100 lateral unicompartmental arthroplasties. Indications were complete lateral bone-on-bone arthrosis with a correctible deformity and maintenance of the medial joint space on varus stress radiographs or isolated lateral disease by diagnostic arthroscopy. Average age was 68 years. Seventy percent of patients were women. At followup, we obtained Knee Society scores and ROM. Minimum followup was 24 months (average, 39 months; range, 24-81 months).

Results: At followup, Knee Society scores averaged 46 for pain, 94 for clinical, and 89 for function, and ROM averaged 124°. Three patients had reoperations: one an open reduction and internal fixation for fracture at 2 years postoperatively, one an arthroscopy for a medial meniscal tear, and one a revision for pain.

Conclusions: Based on our observations, we believe complete cartilage loss laterally and correctible deformity with maintenance of the medial joint on varus stress radiographs are reasonable indications for lateral unicompartmental arthroplasty. We recommend a lateral parapatellar approach can be utilized. The early reoperation and revision rates were low.

Figures

Fig. 1
Fig. 1
An intraoperative photograph demonstrates the vertical tibial resection through the patellar tendon split.
Fig. 2
Fig. 2
A photograph shows how we perform the lateral parapatellar approach in a cadaveric specimen. To facilitate accurate internal rotation and medial placement of the tibial baseplate, we performed vertical resection through a slit in the patellar tendon.
Fig. 3
Fig. 3
An AP radiograph shows the resurfacing femoral component with a modular, metal-backed, fixed-bearing tibial baseplate (Repicci II®) used in 43 LUKAs.
Fig. 4
Fig. 4
An AP radiograph shows the spherical femoral component with a nonmodular, metal-backed, fixed-bearing direct compression-molded tibial design (Vanguard M™) used in 90 LUKAs.

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