SHORT-TERM EFFECTIVENESS OF UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR MEDIAL COMPARTMENTAL KNEE OSTEOARTHRITIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MAGuangwen ,  YINZongsheng , HUANGFei , WANGQing , YINYong , WANGHao , WUYunfeng , LIJiahua

Department of Orthopedics, the Fourth Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230022, P. R. China;

Corresponding author：

YINZongsheng, Email: yinzongsheng2013@126.com

Keywords：

Knee; Medial compartment; Osteoarthritis; Unicompartmental knee arthroplasty

DOI：

10.7507/1002-1892.20140262

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Objective To evaluate the short-term effectiveness of unicompartmental knee arthroplasty (UKA) for medial compartmental osteoarthritis of the knee. Methods Between January 2008 and October 2013, 18 patients with medial compartmental osteoarthritis of the knee were treated by UKA, including 11 males and 7 females with an average age of 67.2 years (range, 60-72 years). The disease duration ranged from 3 to 5 years (mean, 3.7 years). All patients had loading pain and walk-associated pain of the medial compartmental knee. The preoperative visual analogue scale (VAS) score was 6.8±1.4. The full-length radiograph of lower limb and anteroposterior and lateral radiographs of the knee showed medial compartmental osteoarthritis of the knee. According to Ahlback staging, 8 knees were at stageⅡand 10 knees at stageⅢ. The knee range of motion (ROM) was (112.3±11.3)°, and the angle of genu varus was (13.2±1.3)°. The American Hospital for Special Surgery (HSS) score was 59.0±6.4. Results Primary healing of incision was obtained in all patients, and no infection or lower limb deep venous thrombosis occurred. All of the patients were followed up 6-50 months (mean, 28 months). No prosthetic loosening and dislocation or lesions of contralateral compartment and patellofemoral joint developed. At 6 months after operation, the VAS score was significantly reduced to 2.8±1.2 (t=9.20, P=0.00); most of patients achieved significant relief of pain. The HSS score was significantly increased to 92.0±3.1 (t=19.69, P=0.00); and the results were excellent in 12 cases, good in 5 cases, and poor in 1 case, with an excellent and good rate of 94.4%. The knee ROM was (115.2±10.2)°, showing no significant difference when compared with preoperative one (t=-0.81, P=0.23). The alignment of limbs showed that the angle of genu varus was significantly reduced to (6.8±2.1)° (t=10.99, P=0.00). Conclusion UKA has satisfactory short-term effectiveness in the treatment of medial compartmental knee osteoarthritis, however, long-term effectiveness need further studies.

Citation： MAGuangwen, YINZongsheng, HUANGFei, WANGQing, YINYong, WANGHao, WUYunfeng, LIJiahua. SHORT-TERM EFFECTIVENESS OF UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR MEDIAL COMPARTMENTAL KNEE OSTEOARTHRITIS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1208-1211. doi: 10.7507/1002-1892.20140262 Copy

1.	Insall J, Aglietti P.A five to seven-year follow-up of unicondylar arthroplasty.J Bone Joint Surg (Am), 1980, 62(8):1329-1337.
2.	Jamali AA, Scott RD, Rubash HE, et al.Unicompartmental knee arthroplasty:past, present, and future.Am J Orthop, 2009, 38(1):17-23.
3.	Newman J, Pydisetty RV, Ackroyd C.Unicompartmental or total knee replacement:the 15-year results of a prospective randomised controlled trial.J Bone Joint Surg (Br), 2009, 91(1):52-57.
4.	Berger RA, Meneghini RM, Jacobs JJ, et al.Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up.J Bone Joint Surg (Am), 2005, 87(5):999-1006.
5.	林松, 许建中, 王佰川, 等.单髁与全膝置换治疗老年膝单间室骨性关节炎远期疗效的meta分析.郑州大学学报:医学版, 2013, 48(5):664-668.
6.	张启栋, 郭万首, 刘朝晖, 等.胫骨高位截骨与单髁关节置换治疗膝关节单间室骨关节炎的荟萃分析.中华医学杂志, 2009, 89(39):2768-2772.
7.	Fu D, Li G, Chen K, et al.Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis:a meta-analysis.J Arthroplasty, 2013, 28(5):759-765.
8.	Dettoni F, Bonasia DE, Castoldi F, et al.High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee:a review of the literature.Iowa Orthop J, 2010, 30:131-140.
9.	Borus T, Thornhill T.Unicompartmental knee arthroplasty.J Am Acad Orthop Surg, 2008, 16(1):9-18.
10.	Pennington DW, Swienckowski JJ, Lutes WB, et al.Lateral unicompartmental knee arthroplasty:survivorship and technical considerations at an average follow-up of 12.4 years.J Arthroplasty, 2006, 21(1):13-17.
11.	Price AJ, Waite JC, Svard U.Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty.Clin Orthop Relat Res, 2005, (435):171-180.
12.	Lewold S, Goodman S, Knutson K, et al.Oxford meniscal bearing knee versus the Marmor knee in unicompartmental arthroplasty for arthrosis.A Swedish multicenter survival study.J Arthroplasty, 1995, 10(6):722-731.
13.	Schroer WC, Barnes CL, Diesfeld P, et al.The Oxford unicompartmental knee fails at a high rate in a high-volume knee practice.Clin Orthop Relat Res, 2013, 471(11):3533-3539.
14.	Bolognesi MP, Greiner MA, Attarian DE, et al.Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009.J Bone Joint Surg (Am), 2013, 95(22):e174.
15.	Deschamps G, Chol C.Fixed-bearing unicompartmentalknee arthroplasty.Patients' selection and operative technique.Orthop Traumatol Surg Res, 2011, 97(6):648-661.
16.	Kennedy WR, White RP.Unicompartmental arthroplasty of the knee postoperative alignment and its influence on overall results.Clin Orthop Relat Res, 1987, (221):278-285.
17.	唐恒涛, 赵亮, 燕华, 等.OxfordⅢ单髁系统治疗膝关节内侧间室退变的中期疗效.中国修复重建外科杂志, 2012, 26(1):17-20.
18.	Ollivier M, Parratte S, Argenson JN.Results and outcomes of unicompartmental knee arthroplasty.Orthop Clin North Am, 2013, 44(3):287-300, vii-viii.

1. Insall J, Aglietti P.A five to seven-year follow-up of unicondylar arthroplasty.J Bone Joint Surg (Am), 1980, 62(8):1329-1337.
2. Jamali AA, Scott RD, Rubash HE, et al.Unicompartmental knee arthroplasty:past, present, and future.Am J Orthop, 2009, 38(1):17-23.
3. Newman J, Pydisetty RV, Ackroyd C.Unicompartmental or total knee replacement:the 15-year results of a prospective randomised controlled trial.J Bone Joint Surg (Br), 2009, 91(1):52-57.
4. Berger RA, Meneghini RM, Jacobs JJ, et al.Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up.J Bone Joint Surg (Am), 2005, 87(5):999-1006.
5. 林松, 许建中, 王佰川, 等.单髁与全膝置换治疗老年膝单间室骨性关节炎远期疗效的meta分析.郑州大学学报:医学版, 2013, 48(5):664-668.
6. 张启栋, 郭万首, 刘朝晖, 等.胫骨高位截骨与单髁关节置换治疗膝关节单间室骨关节炎的荟萃分析.中华医学杂志, 2009, 89(39):2768-2772.
7. Fu D, Li G, Chen K, et al.Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis:a meta-analysis.J Arthroplasty, 2013, 28(5):759-765.
8. Dettoni F, Bonasia DE, Castoldi F, et al.High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee:a review of the literature.Iowa Orthop J, 2010, 30:131-140.
9. Borus T, Thornhill T.Unicompartmental knee arthroplasty.J Am Acad Orthop Surg, 2008, 16(1):9-18.
10. Pennington DW, Swienckowski JJ, Lutes WB, et al.Lateral unicompartmental knee arthroplasty:survivorship and technical considerations at an average follow-up of 12.4 years.J Arthroplasty, 2006, 21(1):13-17.
11. Price AJ, Waite JC, Svard U.Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty.Clin Orthop Relat Res, 2005, (435):171-180.
12. Lewold S, Goodman S, Knutson K, et al.Oxford meniscal bearing knee versus the Marmor knee in unicompartmental arthroplasty for arthrosis.A Swedish multicenter survival study.J Arthroplasty, 1995, 10(6):722-731.
13. Schroer WC, Barnes CL, Diesfeld P, et al.The Oxford unicompartmental knee fails at a high rate in a high-volume knee practice.Clin Orthop Relat Res, 2013, 471(11):3533-3539.
14. Bolognesi MP, Greiner MA, Attarian DE, et al.Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009.J Bone Joint Surg (Am), 2013, 95(22):e174.
15. Deschamps G, Chol C.Fixed-bearing unicompartmentalknee arthroplasty.Patients' selection and operative technique.Orthop Traumatol Surg Res, 2011, 97(6):648-661.
16. Kennedy WR, White RP.Unicompartmental arthroplasty of the knee postoperative alignment and its influence on overall results.Clin Orthop Relat Res, 1987, (221):278-285.
17. 唐恒涛, 赵亮, 燕华, 等.OxfordⅢ单髁系统治疗膝关节内侧间室退变的中期疗效.中国修复重建外科杂志, 2012, 26(1):17-20.
18. Ollivier M, Parratte S, Argenson JN.Results and outcomes of unicompartmental knee arthroplasty.Orthop Clin North Am, 2013, 44(3):287-300, vii-viii.

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Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFFECTIVENESS OF UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR MEDIAL COMPARTMENTAL KNEE OSTEOARTHRITIS

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