Skip to main content
Erschienen in: International Orthopaedics 12/2015

01.12.2015 | Original Paper

Unicompartmental knee arthroplasty is effective: ten year results

verfasst von: Michele Vasso, Chiara Del Regno, Carlo Perisano, Antonio D’Amelio, Katia Corona, Alfredo Schiavone Panni

Erschienen in: International Orthopaedics | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Unicompartmental knee arthroplasty (UKA) presents low morbidity and complication risk and provides excellent outcomes and fast recovery. Despite these facts, knee-replacement registries have shown high failure rates for UKA, especially when compared with traditional TKA. The purpose of this study was therefore to report outcomes, complications, and ten year survivorship rate of medial ZUK unicompartmental knee prosthesis.

Methods

We retrospectively analysed 136 medial UKAs in 124 patients, with a maximum follow-up of ten years. Patients were assessed through the International Knee Society (IKS) scores and range of motion (ROM). A complete X-ray study was performed in all patients. Limb alignment was assessed by measuring the femorotibial mechanical alignment. At surgery, bone resections were performed according to proximal tibial epiphyseal axis.

Results

Mean IKS knee score improved from 45.7 (range 35–63) points preoperatively to 87.2 (range 71–100) points at the latest follow-up. Mean IKS function score improved from 50.9 (range 40–70) points to 89.1 (range 75–100) points (p < 0.05). Mean ROM increased from 106.1° (range 98–123°) to 128.6° (range 116–139°) (p < 0.01). Four cases (2.9 %) were revised due to failure for any cause, so that survivorship was 97.1 % at the latest follow-up.

Conclusions

This study demonstrates excellent outcomes and survivorship for the ZUK unicompartmental knee prosthesis. Based on our findings, we believe that the ZUK prosthesis offers an effective and durable solution for treating medial degeneration of the knee.
Level of Evidence IV - Retrospective case series study
Literatur
1.
Zurück zum Zitat Panni AS, Vasso M, Cerciello S, Felici A (2012) Unicompartmental knee replacement provides early clinical and functional improvement stabilizing over time. Knee Surg Sports Traumatol Arthrosc 20:579–585CrossRefPubMed Panni AS, Vasso M, Cerciello S, Felici A (2012) Unicompartmental knee replacement provides early clinical and functional improvement stabilizing over time. Knee Surg Sports Traumatol Arthrosc 20:579–585CrossRefPubMed
2.
Zurück zum Zitat Foran JR, Brown NM, Della Valle CJ, Berger RA, Galante JO (2013) Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res 471:102–108PubMedCentralCrossRefPubMed Foran JR, Brown NM, Della Valle CJ, Berger RA, Galante JO (2013) Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res 471:102–108PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Koshino T, Sato K, Umemoto Y, Akamatsu Y, Kumagai K, Saito T (2014) Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation. Int Orthop. doi:10.1007/s00264-014-2564-y PubMed Koshino T, Sato K, Umemoto Y, Akamatsu Y, Kumagai K, Saito T (2014) Clinical results of unicompartmental arthroplasty for knee osteoarthritis using a tibial component with screw fixation. Int Orthop. doi:10.​1007/​s00264-014-2564-y PubMed
4.
Zurück zum Zitat Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, Bontemps G (2014) Ten year survivorship after cemented and uncemented medial Uniglide® unicompartmental knee arthroplasties. Knee 21:964–970CrossRefPubMed Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, Bontemps G (2014) Ten year survivorship after cemented and uncemented medial Uniglide® unicompartmental knee arthroplasties. Knee 21:964–970CrossRefPubMed
5.
Zurück zum Zitat Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9 Suppl):168–171CrossRefPubMed Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9 Suppl):168–171CrossRefPubMed
6.
Zurück zum Zitat Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2014) Total versus unicompartmental knee replacement for isolated lateral osteoarthritis: a matched-pairs study. Int Orthop 38:2259–2264CrossRefPubMed Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2014) Total versus unicompartmental knee replacement for isolated lateral osteoarthritis: a matched-pairs study. Int Orthop 38:2259–2264CrossRefPubMed
7.
Zurück zum Zitat Lim JW, Cousins GR, Clift BA, Ridley D, Johnston LR (2014) Oxford unicompartmental knee arthroplasty versus age and gender matched total knee arthroplasty—functional outcome and survivorship analysis. J Arthroplasty 29:1779–1783CrossRefPubMed Lim JW, Cousins GR, Clift BA, Ridley D, Johnston LR (2014) Oxford unicompartmental knee arthroplasty versus age and gender matched total knee arthroplasty—functional outcome and survivorship analysis. J Arthroplasty 29:1779–1783CrossRefPubMed
8.
Zurück zum Zitat Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P (2014) Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3131-1 Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P (2014) Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3131-1
9.
Zurück zum Zitat Jahnke A, Mende JK, Maier GS, Ahmed GA, Ishaque BA, Schmitt H, Rickert M, Clarius M, Seeger JB (2015) Sports activities before and after medial unicompartmental knee arthroplasty using the new Heidelberg Sports Activity Score. Int Orthop 39:449–454CrossRefPubMed Jahnke A, Mende JK, Maier GS, Ahmed GA, Ishaque BA, Schmitt H, Rickert M, Clarius M, Seeger JB (2015) Sports activities before and after medial unicompartmental knee arthroplasty using the new Heidelberg Sports Activity Score. Int Orthop 39:449–454CrossRefPubMed
10.
Zurück zum Zitat Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470:84–90PubMedCentralCrossRefPubMed Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470:84–90PubMedCentralCrossRefPubMed
11.
Zurück zum Zitat Niinimaki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI (2011) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 18:432–435CrossRefPubMed Niinimaki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI (2011) Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee 18:432–435CrossRefPubMed
12.
Zurück zum Zitat Schmiegelow MD, Andersson C, Køber L, Andersen SS, Norgaard ML, Jensen TB, Gislason G, Berger SM, Torp-Pedersen C (2014) Associations between body mass index and development of metabolic disorders in fertile women-a nationwide cohort study. J Am Heart Assoc 3, e000672PubMedCentralCrossRefPubMed Schmiegelow MD, Andersson C, Køber L, Andersen SS, Norgaard ML, Jensen TB, Gislason G, Berger SM, Torp-Pedersen C (2014) Associations between body mass index and development of metabolic disorders in fertile women-a nationwide cohort study. J Am Heart Assoc 3, e000672PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
14.
Zurück zum Zitat Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22:117–121CrossRefPubMed Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22:117–121CrossRefPubMed
15.
Zurück zum Zitat Dao Trong ML, Diezi C, Goerres G, Helmy N (2014) Improved positioning of the tibial component in unicompartmental knee arthroplasty with patient-specific cutting blocks. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2839-2 PubMed Dao Trong ML, Diezi C, Goerres G, Helmy N (2014) Improved positioning of the tibial component in unicompartmental knee arthroplasty with patient-specific cutting blocks. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-2839-2 PubMed
16.
Zurück zum Zitat Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165CrossRefPubMed Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165CrossRefPubMed
17.
Zurück zum Zitat 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 84:2235–2239PubMed 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 84:2235–2239PubMed
18.
Zurück zum Zitat Lustig S, Paillot J, Servien E, Henry J, Ait Si Selmi T, Neyret P (2009) Cemented all polyethylene tibial insert unicompartmental knee arthroplasty: a long term follow-up study. Arch Orthop Trauma Surg 129:617–624CrossRef Lustig S, Paillot J, Servien E, Henry J, Ait Si Selmi T, Neyret P (2009) Cemented all polyethylene tibial insert unicompartmental knee arthroplasty: a long term follow-up study. Arch Orthop Trauma Surg 129:617–624CrossRef
19.
Zurück zum Zitat Zambianchi F, Digennaro V, Giorgini A, Grandi G, Fiacchi F, Mugnai R, Catani F (2014) Surgeon’s experience influences UKA survivorship: a comparative study between all-poly and metal back designs. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2958-9 Zambianchi F, Digennaro V, Giorgini A, Grandi G, Fiacchi F, Mugnai R, Catani F (2014) Surgeon’s experience influences UKA survivorship: a comparative study between all-poly and metal back designs. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-2958-9
20.
Zurück zum Zitat Emerson RH Jr, Higgins LL (2008) Unicompartmental knee arthroplasty with the Oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 90:118–122CrossRefPubMed Emerson RH Jr, Higgins LL (2008) Unicompartmental knee arthroplasty with the Oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 90:118–122CrossRefPubMed
21.
Zurück zum Zitat Hall MJ, Conell DA, Morris HG (2013) Medium to long-term results of the UNIX uncemented unicompartmental knee replacement. Knee 20:328–331CrossRefPubMed Hall MJ, Conell DA, Morris HG (2013) Medium to long-term results of the UNIX uncemented unicompartmental knee replacement. Knee 20:328–331CrossRefPubMed
22.
Zurück zum Zitat Koskinen E, Paavolainen P, Eskelinen A, Harilainen Ä, Sandelin J, Ylinen P, Tallroth K, Remes V (2009) Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: midterm clinical and radiographic results. Arch Orthop Trauma Surg 129:617–624CrossRefPubMed Koskinen E, Paavolainen P, Eskelinen A, Harilainen Ä, Sandelin J, Ylinen P, Tallroth K, Remes V (2009) Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: midterm clinical and radiographic results. Arch Orthop Trauma Surg 129:617–624CrossRefPubMed
23.
Zurück zum Zitat Berend KR, Morris MJ, Skeels MD, Lombardi AV Jr, Adams JB (2011) Perioperative complications of simultaneous versus staged unicompartmental knee arthroplasty. Clin Orthop Relat Res 469:168–173PubMedCentralCrossRefPubMed Berend KR, Morris MJ, Skeels MD, Lombardi AV Jr, Adams JB (2011) Perioperative complications of simultaneous versus staged unicompartmental knee arthroplasty. Clin Orthop Relat Res 469:168–173PubMedCentralCrossRefPubMed
25.
Zurück zum Zitat Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for H, Knee (2012) Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res 98(6 Suppl):S124–S130CrossRefPubMed Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for H, Knee (2012) Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res 98(6 Suppl):S124–S130CrossRefPubMed
Metadaten
Titel
Unicompartmental knee arthroplasty is effective: ten year results
verfasst von
Michele Vasso
Chiara Del Regno
Carlo Perisano
Antonio D’Amelio
Katia Corona
Alfredo Schiavone Panni
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 12/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2809-4

Weitere Artikel der Ausgabe 12/2015

International Orthopaedics 12/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.