eMedicine Specialties > Orthopedic Surgery > Knee

Unicompartmental Knee Arthroplasty: Follow-up

Author: Nanne P Kort, MD, Consulting Staff, Department of Orthopedic Surgery, Maasland Hospital Sittard, The Netherlands
Coauthor(s): Marcus Romanowski, MD, Consulting Surgeon, Department of Orthopedic Surgery, Joint Reconstruction Orthopedic Center; Jos van Raay, PhD, Associate Chair, Residency Director, Department of Orthopedic Surgery, Martini Hospital Groningen, Netherlands
Contributor Information and Disclosures

Updated: Jan 5, 2007

Outcome and Prognosis

When nonoperative and, possibly, arthroscopic procedures fail, the surgeon may consider HTO, unicompartmental arthroplasty, or total knee arthroplasty. Unicompartmental knee arthroplasty appears to result in better function and pain relief, less morbidity, and higher patient satisfaction than do HTO and total knee arthroplasty. The long-term survival rate for unicompartmental knee arthroplasty is better than that for HTO and comparable to the long-term survival rate for a total knee arthroplasty. With strict indications, newer prostheses, and attention to surgical technique, unicompartmental knee arthroplasty has become a valuable treatment for unicompartmental knee arthritis.

Future and Controversies

As the population ages and grows, the number of people with symptoms attributable to unicompartmental knee osteoarthritis will increase. The unicompartmental knee arthroplasty offers a more physiologic alternative to HTO or total knee arthroplasty. Progress has been made in the design and implantation of unicompartmental knee arthroplasty, in particular for the medial compartment. However, complications still occur, and surgical expertise remains the most important factor in determining a successful outcome.

Whether refinement of prosthetic design and technique will make lateral compartment arthroplasty as reliable as the medial procedure remains to be seen.

 


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References
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References

  1. Ahlback S. Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh). 1968;Suppl 277: 7-72. [Medline].

  2. Amin AK, Patton JT, Cook RE, et al. Unicompartmental or total knee arthroplasty?: Results from a matched study. Clin Orthop Relat Res. Oct 2006;451:101-6. [Medline].

  3. Argenson JN, Chevrol-Benkeddache Y, Aubaniac JM. Modern unicompartmental knee arthroplasty with cement: a three to ten-year follow-up study. J Bone Joint Surg Am. Dec 2002;84-A(12):2235-9. [Medline].

  4. Argenson JN, Parratte S. The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res. Nov 2006;452:137-42. [Medline].

  5. Baré JV, Gill HS, Beard DJ, Murray DW. A convex lateral tibial plateau for knee replacement. Knee. Mar 2006;13(2):122-6. [Medline].

  6. Berger RA, Jacobs JJ, Meneghini RM, et al. Rapid rehabilitation and recovery with minimally invasive total hip arthroplasty. Clin Orthop Relat Res. Dec 2004;239-47.

  7. Broughton NS, Newman JH, Baily RA. Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5-10 years' follow-up. J Bone Joint Surg Br. May 1986;68(3):447-52. [Medline].

  8. Brumby SA, Thornhill TS. Unicompartmental Osteoarthritis of the Knee. In: Laskin RS, ed. Controversies in Total Knee Replacement. Oxford, UK: Oxford University Press; 2001: 285-312.

  9. Callaghan JJ. Unicompartmental knee replacement: introduction: where have we been? Where are we now? Where are we going?. Clin Orthop Relat Res. Jan 2005;(430):272-3. [Medline].

  10. Cameron HU, Jung YB. A comparison of unicompartmental knee replacement with total knee replacement. Orthop Rev. Oct 1988;17(10):983-8. [Medline].

  11. Carr A, Keyes G, Miller R, et al. Medial unicompartmental arthroplasty. A survival study of the Oxford meniscal knee. Clin Orthop Relat Res. Oct 1993;205-13. [Medline].

  12. Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty. Oct 1996;11(7):782-8. [Medline].

  13. Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG. Functional analysis of cemented medial unicompartmental knee arthroplasty. J Arthroplasty. Aug 1996;11(5):553-9. [Medline].

  14. [Best Evidence] Cobb J, Henckel J, Gomes P, et al. Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br. Feb 2006;88(2):188-97. [Medline].

  15. Cossey AJ, Spriggins AJ. The use of computer-assisted surgical navigation to prevent malalignment in unicompartmental knee arthroplasty. J Arthroplasty. Jan 2005;20(1):29-34. [Medline].

  16. Emerton ME, Burton D. The role of unicompartmental knee replacement. Curr Orthop. 2001;15(6):406-12.

  17. Engh GA, Ammeen D. Is an intact anterior cruciate ligament needed in order to have a well-functioning unicondylar knee replacement?. Clin Orthop Relat Res. Nov 2004;(428):170-3. [Medline].

  18. Goodfellow J, O'Connor J. The mechanics of the knee and prosthesis design. J Bone Joint Surg Br. Aug 1978;60-B(3):358-69. [Medline].

  19. Gunston FH. Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg Br. May 1971;53(2):272-7. [Medline].

  20. Gunther T, Murray DW, Miller R. Lateral unicompartmental arthroplasty with the Oxford meniscal knee. Knee. 1996;3:33-9.

  21. Heck DA, Marmor L, Gibson A, Rougraff BT. Unicompartmental knee arthroplasty. A multicenter investigation with long-term follow-up evaluation. Clin Orthop Relat Res. Jan 1993;154-9. [Medline].

  22. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. Dec 1980;62(8):1329-37. [Medline].

  23. Jackson M, Sarangi PP, Newman JH. Revision total knee arthroplasty. Comparison of outcome following primary proximal tibial osteotomy or unicompartmental arthroplasty. J Arthroplasty. Oct 1994;9(5):539-42. [Medline].

  24. Jenny JY. Navigated unicompartmental knee replacement. Orthopedics. Oct 2005;28(10 Suppl):s1263-7. [Medline].

  25. Keene G, Simpson D, Kalairajah Y. Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Joint Surg Br. Jan 2006;88(1):44-8. [Medline].

  26. Keys GW. Reduced invasive approach for Oxford II medial unicompartmental knee replacement—a preliminary study. Knee. Aug 1999;6(3):193-6.

  27. Knutson K, Lewold S, Robertsson O, et al. The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992. Acta Orthop Scand. Aug 1994;65(4):375-86. [Medline].

  28. Laskin RS. Unicompartmental knee replacement: some unanswered questions. Clin Orthop Relat Res. Nov 2001;(392):267-71. [Medline].

  29. Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am. Mar 1978;60(2):182-5. [Medline].

  30. Laurencin CT, Zelicof SB, Scott RD, Ewald FC. Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res. Dec 1991;151-6. [Medline].

  31. Levine WN, Ozuna RM, Scott RD. Conversion of failed modern unicompartmental arthroplasty or high tibial osteotomy. Clin Orthop. Oct 1995;321:10-18.

  32. Li MG, Yao F, Joss B, et al. Mobile vs. fixed bearing unicondylar knee arthroplasty: A randomized study on short term clinical outcomes and knee kinematics. Knee. Oct 2006;13(5):365-70. [Medline].

  33. Luscombe KL, Lim J, Jones PW, White SH. Minimally invasive Oxford medial unicompartmental knee arthroplasty : A note of caution!. Int Orthop. Aug 1 2006;[Medline].

  34. MacIntosh DL. Hemiarthroplasty of the knee using a space occupying prosthesis for painful varus and valgus deformities. J Bone Joint Surg Am. 1958;40A:1431.

  35. Manzotti A, Confalonieri N, Pullen C. Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. Int Orthop [serial online]. Aug 2 2006;[Medline].

  36. Marmor L. Unicompartmental arthroplasty of the knee with a minimum ten-year follow-up period. Clin Orthop Relat Res. Mar 1988;(228):171-7. [Medline].

  37. Marmor L. Unicompartmental knee arthroplasty. Ten- to 13-year follow-up study. Clin Orthop Relat Res. Jan 1988;(226):14-20. [Medline].

  38. McAuley JP, Engh GA, Ammeen DJ. Revision of failed unicompartmental knee arthroplasty. Clin Orthop Relat Res. Nov 2001;279-82. [Medline].

  39. McKeever DC. Tibial plateau prosthesis. Clin Orthop. 1960;18:86-95.

  40. Muller PE, Pellengahr C, Witt M, et al. Influence of minimally invasive surgery on implant positioning and the functional outcome for medial unicompartmental knee arthroplasty. J Arthroplasty. Apr 2004;19(3):296-301. [Medline].

  41. Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br. Nov 1998;80(6):983-9. [Medline].

  42. Murray DW. Mobile bearing unicompartmental knee replacement. Orthopedics. Sep 2005;28(9):985-7. [Medline].

  43. Padgett DE, Stern SH, Insall JN. Revision total knee arthroplasty for failed unicompartmental replacement. J Bone Joint Surg Am. Feb 1991;73(2):186-90. [Medline].

  44. Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Lateral unicompartmental knee arthroplasty: survivorship and technical considerations at an average follow-up of 12.4 years. J Arthroplasty. Jan 2006;21(1):13-7. [Medline].

  45. Psychoyios V, Crawford RW, O'Connor JJ, Murray DW. Wear of congruent meniscal bearings in unicompartmental knee arthroplasty: a retrieval study of 16 specimens. J Bone Joint Surg Br. Nov 1998;80(6):976-82. [Medline].

  46. Rees JL, Price AJ, Lynskey TG, et al. Medial unicompartmental arthroplasty after failed high tibial osteotomy. J Bone Joint Surg Br. Sep 2001;83(7):1034-6. [Medline].

  47. Reilly KA, Beard DJ, Barker KL, et al. Efficacy of an accelerated recovery protocol for Oxford unicompartmental knee arthroplasty--a randomised controlled trial. Knee. Oct 2005;12(5):351-7. [Medline].

  48. Robertsson O, Borgquist L, Knutson K, et al. Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental p. Acta Orthop Scand. Apr 1999;70(2):170-5. [Medline].

  49. Rougraff BT, Heck DA, Gibson AE. A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res. Dec 1991;(273):157-64. [Medline].

  50. Rush J. Unicompartmental knee joint replacement. Curr Orthop. 2001;15(2):143-7.

  51. Sah AP, Springer BD, Scott RD. Unicompartmental knee arthroplasty in octogenarians: survival longer than the patient. Clin Orthop Relat Res. Oct 2006;(451):107-12. [Medline].

  52. Sculco TP. Orthopaedic crossfire--can we justify unicondylar arthroplasty as a temporizing procedure? In opposition. J Arthroplasty. Jun 2002;17(4 Suppl 1):56-8. [Medline].

  53. Springer BD, Scott RD, Thornhill TS. Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res. May 2006;(446):214-20. [Medline].

  54. Squire MW, Callaghan JJ, Goetz DD, et al. Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop Relat Res. Oct 1999;61-72. [Medline].

  55. Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee. Oct 2001;8(3):187-94. [Medline].

  56. Tabor OB, Tabor OB. Unicompartmental arthroplasty: a long-term follow-up study. J Arthroplasty. Jun 1998;13(4):373-9. [Medline].

  57. Vorlat P, Verdonk R, Schauvlieghe H. The Oxford unicompartmental knee prosthesis: a 5-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2000;8(3):154-8. [Medline].

  58. Weale AE, Murray DW, Crawford R, et al. Does arthritis progress in the retained compartments after 'Oxford' medial unicompartmental arthroplasty? A clinical and radiological study with a minimum ten-year follow-up. J Bone Joint Surg Br. Sep 1999;81(5):783-9. [Medline]. [Full Text].

  59. Weale AE, Newman JH. Unicompartmental arthroplasty and high tibial osteotomy for osteoarthrosis of the knee. A comparative study with a 12- to 17-year follow-up period. Clin Orthop Relat Res. May 1994;(302):134-7. [Medline].

  60. Weale AE, Murray DW, Crawford R, et al. Does arthritis progress in the retained compartments after 'Oxford' medial unicompartmental arthroplasty? A clinical and radiological study with a minimum ten-year follow-up. J Bone Joint Surg Br. Sep 1999;81(5):783-9. [Medline].

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Further Reading

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Keywords

unicompartmental knee replacement, unicondylar knee arthroplasty, uni-knee, uniknee, knee arthritis, total knee arthroplasty, high tibial osteotomy, medial osteoarthritis

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Contributor Information and Disclosures

Author

Nanne P Kort, MD, Consulting Staff, Department of Orthopedic Surgery, Maasland Hospital Sittard, The Netherlands
Disclosure: Nothing to disclose.

Coauthor(s)

Marcus Romanowski, MD, Consulting Surgeon, Department of Orthopedic Surgery, Joint Reconstruction Orthopedic Center
Marcus Romanowski, MD is a member of the following medical societies: Arthritis Foundation
Disclosure: Nothing to disclose.

Jos van Raay, PhD, Associate Chair, Residency Director, Department of Orthopedic Surgery, Martini Hospital Groningen, Netherlands
Disclosure: Nothing to disclose.

Medical Editor

Howard A Chansky, MD, Associate Professor, Department of Orthopedics and Sports Medicine, University of Washington Medical Center
Howard A Chansky, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Thomas M DeBerardino, MD, Director, John A Feagin, Jr Sports Medicine Fellowship at West Point, Clinical Instructor in Surgery, Orthopedic Surgery Service, Keller Army Community Hospital at West Point
Thomas M DeBerardino, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, and American Orthopaedic Society for Sports Medicine
Disclosure: Arthrex, Inc. Grant/research funds None; Arthrex, Inc. Honoraria Speaking and teaching; Genzyme Biosurgery. Inc. Grant/research funds Other; Musculoskeletal Transplant Foundation Grant/research funds Other; Histogenics Grant/research funds None

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Carlos J Lavernia, MD, FAAOS, Adjunct Clinical Professor, Department of Orthopedic Surgery, University of Miami School of Medicine; Medical Director, Orthopedic Institute at Mercy Hospital
Carlos J Lavernia, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, Arthritis Foundation, Biomedical Engineering Society, Florida Orthopaedic Society, and Orthopaedic Research Society
Disclosure: Nothing to disclose.

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