Reliable patient-reported outcome measure and survivorship of UKA for primary spontaneous osteonecrosis

  • Takao KanekoEmail author
  • Norihiko Kono
  • Takahide Sunakawa
  • Yuji Okuno
  • Hiroyasu Ikegami
  • Yoshiro Musha
Original Article • KNEE - ARTHROPLASTY



Primary Spontaneous osteonecrosis of the knee (SPONK) was a result of a subchondral insufficiency fracture based on histopathological examinations. There were few studies examining patients who underwent unicompartmental knee arthroplasty (UKA) for the treatment of primary SPONK. The aim of this study was to investigate (1) patient-reported outcome measure (PROM), (2) survivorship of revision as end point and (3) survivorship of complication as end point in patients with primary SPONK.


The clinical examinations of a consecutive series of 61 medial UKAs for primary SPONK of the medial femoral condyle from 2008 to 2012 were evaluated retrospectively at our institution. There were 18 males and 43 females with a mean age of 73.7 years (60–91). In all patients, preoperative radiographs were analyzed according to the stage of primary SPONK. We conducted Kaplan–Meier survival analyses using revision and complications for any reasons as the end point.


Mean follow-up was 6.6 years (range 6–10). UKA using Physica ZUK (LIMA Corporate. UD, Italy) for SPONK improved patients’ 2011 Knee Society symptom score, patient satisfaction, patient activities, EQ-5D and postoperative ranges of motion compared with their preoperative status (P < 0.01). Revision surgery was required in one knee (1.6%) due to postoperative fracture of the medial tibial plateau after a fall that occurred 6 months postoperatively. The projected rate of survivorship of UKA was 90.4% at 10 years (95% confidence interval 0.80–1). The projected rate of survivorship with complication at end point was 87.7% at 10 years (95% confidence interval 0.76–0.99).


The present study demonstrated that primary spontaneous osteonecrosis of the knee (SPONK) can be successfully be treated with UKA at a mean follow-up of 6.6 years.

Level of evidence



Spontaneous osteonecrosis Knee Unicompartmental knee arthroplasty Survivorship Patient-reported outcome measure 



The authors thank Hiroaki Suzuki for his assistance in this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Takao Kaneko
    • 1
    Email author
  • Norihiko Kono
    • 1
  • Takahide Sunakawa
    • 1
  • Yuji Okuno
    • 2
  • Hiroyasu Ikegami
    • 1
  • Yoshiro Musha
    • 1
  1. 1.Department of Orthopedic SurgeryToho University School of MedicineTokyoJapan
  2. 2.Okuno ClinicTokyoJapan

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