Unicompartmental Knee Arthroplasty

Abstract

Unicompartmental arthroplasty has become the standard of treatment for patients with full loss of cartilage limited to one femorotibial compartment. When the indications are satisfied and the surgical principles respected, it is possible to restore full knee function after UKA. The recent evolution in surgical technique and instrumentation has allowed the surgeon to perform the procedure through a reliable mini-incision approach and to extend the indication to lateral compartment osteoarthritis, osteonecrosis, or post-traumatic disorder.

Keywords

Unicompartmental knee arthroplasty Unicompartmental arthritis of the knee Mini-invasive surgery Knee avascular osteonecrosis Post-traumatic arthritis 

References

  1. 1.
    Parratte S, Argenson JN, Pearce O, Pauly V, Auquier P, Aubaniac JM (2009) Medial unicompartmental knee replacement in the under-50s. J Bone Joint Surg Br 91:351–356PubMedCrossRefGoogle Scholar
  2. 2.
    Argenson JN, Parratte S, Bertani S, Aubniac JM, Lombardi AV Jr et al (2009) The new arthritic patient and arthroplasty treatment options. J Bone Joint Surg Am 91(Suppl 5):43–48PubMedCrossRefGoogle Scholar
  3. 3.
    Flecher X, Parratte S, Aubaniac JM, Argenson JN (2006) A 12-28-year follow-up study of closing wedge high tibial osteotomy. Clin Orthop Relat Res 452:91–96PubMedCrossRefGoogle Scholar
  4. 4.
    Pagnano MW, Clarke HD, Jacofsky DJ, Amendola A, Repicci JA (2005) Surgical treatment of the middle-aged patient with arthritic knees. Instr Course Lect 54:251–259PubMedGoogle Scholar
  5. 5.
    Ahlback S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72Google Scholar
  6. 6.
    Barnes CL, Mesko JW, Teeny SM, York SC (2006) Treatment of medial compartment arthritis of the knee: a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty 21:950–956PubMedCrossRefGoogle Scholar
  7. 7.
    Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM (2002) Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. J Bone Joint Surg Am 84:2235–2239PubMedGoogle Scholar
  8. 8.
    Argenson JN, Flecher X (2004) Minimally invasive unicompartmental knee arthroplasty. Knee 11:341–347PubMedCrossRefGoogle Scholar
  9. 9.
    Argenson JN, Flecher X, Parratte S (2006) Mini-invasive implantation of an uni-compartmental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot 92:193–199PubMedCrossRefGoogle Scholar
  10. 10.
    Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 87:999–1006PubMedCrossRefGoogle Scholar
  11. 11.
    Carlsson LV, Albrektsson BE, Regner LR (2006) Minimally invasive surgery vs conventional exposure using the Miller-Galante unicompartmental knee arthroplasty: a randomized radiostereometric study. J Arthroplasty 21:151–156PubMedCrossRefGoogle Scholar
  12. 12.
    Repicci JA, Eberle RW (1999) Minimally invasive surgical technique for unicondylar knee arthroplasty. J South Orthop Assoc 8:20–27PubMedGoogle Scholar
  13. 13.
    Argenson JN, Parratte S, Flecher X, Aubaniac JM (2007) Unicompartmental knee arthroplasty: technique through a mini-incision. Clin Orthop Relat Res 464:32–36PubMedGoogle Scholar
  14. 14.
    Parratte S, Argenson JN, Dumas J, Aubaniac JM (2007) Unicompartmental knee arthroplasty for avascular osteonecrosis. Clin Orthop Relat Res 464:37–42PubMedGoogle Scholar
  15. 15.
    Gibson PH, Goodfellow JW (1986) Stress radiography in degenerative arthritis of the knee. J Bone Joint Surg Br 68:608–609PubMedGoogle Scholar
  16. 16.
    Price AJ, Dodd CA, Svard UG, Murray DW (2005) Oxford medial unicompartmental knee arthroplasty in patients younger and older than 60 years of age. J Bone Joint Surg Br 87:1488–1492PubMedCrossRefGoogle Scholar
  17. 17.
    Argenson JN, Parratte S (2006) The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res 452:137–142PubMedCrossRefGoogle Scholar
  18. 18.
    Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplasty 18:2–8PubMedCrossRefGoogle Scholar
  19. 19.
    Hamilton WG, Collier MB, Tarabee E, McAuley JP, Engh CA Jr, Engh GA (2006) Incidence and reasons for reoperation after minimally invasive unicompartmental knee arthroplasty. J Arthroplasty 21:98–107PubMedCrossRefGoogle Scholar
  20. 20.
    Pandit H, Jenkins C, Barker K, Dodd CA, Murray DW (2006) The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Joint Surg Br 88:54–60PubMedCrossRefGoogle Scholar
  21. 21.
    Romanowski MR, Repicci JA (2002) Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg 15:17–22PubMedGoogle Scholar
  22. 22.
    Repicci JA (2003) Mini-invasive knee unicompartmental arthroplasty: bone-sparing technique. Surg Technol Int 11:282–286PubMedGoogle Scholar
  23. 23.
    Repicci JA, Hartman JF (2004) Minimally invasive unicondylar knee arthroplasty for the treatment of unicompartmental osteoarthritis: an outpatient arthritic bypass procedure. Orthop Clin North Am 35:201–216PubMedCrossRefGoogle Scholar
  24. 24.
    Romanowski MR, Repicci JA (2003) Technical aspects of medial versus lateral minimally invasive unicondylar arthroplasty. Orthopedics 26:289–293PubMedGoogle Scholar
  25. 25.
    Murray D, Goodfellow J, O’Connor J (1998) The Oxford medial unicompartmental arthroplasty. J Bone Joint Surg Br 80:983–989PubMedCrossRefGoogle Scholar
  26. 26.
    Price A, Wait J, Svärd U (2005) Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 435:171–180PubMedCrossRefGoogle Scholar
  27. 27.
    Vorlat P, Putzeys G, Cottenie D et al (2006) The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis. Knee Surg Sports Traumatol Arthrosc 14:40–45PubMedCrossRefGoogle Scholar
  28. 28.
    US IDE (2004) FDA pre market approach. Summary of safety and effectiveness. P010014. 2004. FDA websiteGoogle Scholar
  29. 29.
    Confalonieri N, Manzotti A, Pullen C (2004) Comparison of a mobile with a fixed tibial bearing unicompartmental knee prosthesis: a prospective randomized trial using a dedicated outcome score. Knee 11:357–362PubMedCrossRefGoogle Scholar
  30. 30.
    Gleeson R, Evans C, Ackroyd J et al (2004) Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. Knee 11:379–384PubMedCrossRefGoogle Scholar
  31. 31.
    Parratte S, Pauly V, Aubaniac JM, Argenson JN (2012) No long-term difference between fixed and mobile medial unicompartmental arthroplasty. Clin Orthop Relat Res 470:61–68PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Price AJ, Short A, Kellett C et al (2005) Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty. J Bone Joint Surg Br 87:1493–1497PubMedCrossRefGoogle Scholar
  33. 33.
    Walton NP, Jahromi I, Lewis PL et al (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19:112–116PubMedGoogle Scholar
  34. 34.
    Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH (2006) Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br 8:1164–1168CrossRefGoogle Scholar
  35. 35.
    Deshmukh RV, Scott RD (2002) Unicompartmental knee arthroplasty for younger patients: an alternative view. Clin Orthop Relat Res 404:108–112PubMedCrossRefGoogle Scholar
  36. 36.
    Ashraf T, Newman JH, Evans RL, Ackroyd CE (2002) Lateral unicompartmental knee replacement survivorship and clinical experience over 21 years. J Bone Joint Surg Br 84:1126–1130PubMedCrossRefGoogle Scholar
  37. 37.
    Gunther T, Murray D, Miller R (1996) Lateral unicompartmental knee arthroplasty with Oxford meniscal knee. Knee 3:33–39CrossRefGoogle Scholar
  38. 38.
    Sah AP, Scott RD (2007) Lateral unicompartmental knee arthroplasty through a medial approach. Study with an average five-year follow-up. J Bone Joint Surg Am 89:1948–1954PubMedCrossRefGoogle Scholar
  39. 39.
    Scott RD (2005) Lateral unicompartmental replacement: a road less traveled. Orthopedics 28:983–984PubMedGoogle Scholar
  40. 40.
    Argenson JN, Parratte S, Bertani A, Flecher X, Aubaniac JM (2008) Long-term results with a lateral unicondylar replacement. Clin Orthop Relat Res 466:2686–2693PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Dennis D, Komistek RD, Hoff WA, Gabriel SM et al (1998) In vivo anteroposterior femorotibial translation: a multicenter analysis. Clin Orthop Relat Res 356:47–57PubMedCrossRefGoogle Scholar
  42. 42.
    Argenson JN, Komistek RD, Aubaniac JM et al (2002) In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty 17:1049–1054PubMedCrossRefGoogle Scholar
  43. 43.
    Weidow J (2006) Lateral osteoarthritis of the knee. Etiology based on morphological, anatomical, kinematic and kinetic observations. Acta Orthop Suppl 77:3–44PubMedGoogle Scholar
  44. 44.
    Aglietti P, Insall JN, Buzzi R, Deschamps D (1983) Idiopathic osteonecrosis of the knee: etiology, prognosis and treatment. J Bone Joint Surg Br 65:588–597Google Scholar
  45. 45.
    Ahlback S, Bauer GCH, Bohne WH (1968) Spontaneous osteonecrosis of the knee. Arthritis Rheum 11:705–733PubMedCrossRefGoogle Scholar
  46. 46.
    Ecker ML (2001) Spontaneous osteonecrosis of the distal femur. Instr Course Lect 50:495–498PubMedGoogle Scholar
  47. 47.
    Mont MA, Baumgarten KM, Rifai A, Bluemke DA, Jones LC, Hungerford DS (2000) Atraumatic osteonecrosis of the knee. J Bone Joint Surg Am 82:1279–1290PubMedGoogle Scholar
  48. 48.
    Myers TG, Cui Q, Kuskowski M, Mihalko WM, Saleh KJ (2006) Outcomes of total and unicompartmental knee arthroplasty for secondary and spontaneous osteonecrosis of the knee. J Bone Joint Surg Am 88(Suppl):76–82PubMedCrossRefGoogle Scholar
  49. 49.
    Marmor L (1993) Unicompartmental arthroplasty for osteonecrosis of the knee joint. Clin Orthop Relat Res 294:247–253PubMedGoogle Scholar
  50. 50.
    Muheim G, Bohne WH (1970) Prognosis in spontaneous osteonecrosis of the knee. J Bone Joint Surg Br 52:605–612PubMedGoogle Scholar
  51. 51.
    Carro LP, Cimiano JG, Del Alamo GG, Suarez GG (1996) Core decompression and arthroscopic bone grafting for avascular necrosis of the knee. Arthroscopy 12:323–326CrossRefGoogle Scholar
  52. 52.
    Mont MA, Tomek IM, Hungerford DS (1997) Core decompression for avascular necrosis of the distal femur: long term follow-up. Clin Orthop Relat Res 334:124–130PubMedCrossRefGoogle Scholar
  53. 53.
    Bergman NR, Rand JA (1991) Total knee arthroplasty in osteonecrosis. Clin Orthop Relat Res 273:77–82PubMedGoogle Scholar
  54. 54.
    Lotke PA, Battish R, Nelson CL (2001) Treatment of osteonecrosis of the knee. Instr Course Lect 50:483–488PubMedGoogle Scholar
  55. 55.
    Mont MA, Rifai A, Baumgarten KM, Sheldon M, Hungerford DS (2002) Total knee arthroplasty for osteonecrosis. J Bone Joint Surg Am 84:599–603PubMedGoogle Scholar
  56. 56.
    Atsui K, Tateishi H, Futani H, Maruo S (1997) Ceramic unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee joint. Bull Hosp Jt Dis 56:233–236PubMedGoogle Scholar
  57. 57.
    Lotke PA, Abend JA, Ecker ML (1982) The treatment of osteonecrosis of the medial femoral condyle. Clin Orthop Relat Res 171:109–116PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Orthopedics and Traumatology, Institute for LocomotionHôpital St. MargueriteMarseilleFrance

Personalised recommendations