Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 1/2013

01.01.2013 | Symposium: Papers Presented at the Annual Meetings of the Knee Society

Long-term Survivorship and Failure Modes of Unicompartmental Knee Arthroplasty

verfasst von: Jared R. H. Foran, MD, Nicholas M. Brown, MD, Craig J. Della Valle, MD, Richard A. Berger, MD, Jorge O. Galante, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

In a previously reported series of 51 patients with 62 cemented, fixed-bearing unicompartmental knee arthroplasties, we reported a 10-year, 98% survival rate with an average knee score of 92 points. The survivorship and modes of failure past 10 years are incompletely understood.

Questions/Purposes

At 15-year followup we sought to determine (1) the overall durability and survivorship of this design; (2) modes of failure; and (3) the progression of arthritis in the nonresurfaced compartments.

Methods

Nineteen knees in 16 patients were available for study with 34 patients lost to death and one lost to followup. At 15 years, we analyzed the Kaplan-Meier survivorship as well as durability with regard to radiographic loosening and knee scores, determined modes of failure, and assessed radiographs for degeneration in the nonresurfaced compartments.

Results

Fifteen-year survivorship was 93% and 20-year survivorship was 90%. Four of 62 knees were revised to total knee arthroplasty at a mean of 144 months. One knee was revised for patellofemoral and lateral compartment degeneration, one for lateral compartment degeneration, one for polyethylene disengagement and metallosis, and one for pain of unclear etiology. No patients had aseptic loosening or osteolysis. The mean knee score was 78 at latest followup. Arthritic progression in the nonresurfaced compartments was common although symptomatic in only two patients.

Conclusions

With this cemented, fixed-bearing design, the failure rates were low, there were no cases of failure secondary to wear or loosening, and the survivorship was similar to that reported for total knee arthroplasty.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Abdeen AR, Collen SB, Vince KG. Fifteen-year to 19-year follow-up of the Insall-Burstein-1 total knee arthroplasty. J Arthroplasty. 2010;25:173–178.PubMedCrossRef Abdeen AR, Collen SB, Vince KG. Fifteen-year to 19-year follow-up of the Insall-Burstein-1 total knee arthroplasty. J Arthroplasty. 2010;25:173–178.PubMedCrossRef
2.
Zurück zum Zitat Ansari S, Newman JH, Ackroyd CE. St. Georg sledge for medial compartment knee replacement. 461 arthroplasties followed for 4 (1–17) years. Acta Orthop Scand. 1997;68:430–434.PubMedCrossRef Ansari S, Newman JH, Ackroyd CE. St. Georg sledge for medial compartment knee replacement. 461 arthroplasties followed for 4 (1–17) years. Acta Orthop Scand. 1997;68:430–434.PubMedCrossRef
3.
Zurück zum Zitat 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. 2002;84:2235–2239.PubMed 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. 2002;84:2235–2239.PubMed
4.
Zurück zum Zitat Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87:999–1006.PubMedCrossRef Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87:999–1006.PubMedCrossRef
5.
Zurück zum Zitat Berger RA, Meneghini RM, Sheinkop MB, Della Valle CJ, Jacobs JJ, Rosenberg AG, Galante JO. The progression of patellofemoral arthrosis after medial unicompartmental replacement: results at 11 to 15 years. Clin Orthop Relat Res. 2004;428:92–99.PubMedCrossRef Berger RA, Meneghini RM, Sheinkop MB, Della Valle CJ, Jacobs JJ, Rosenberg AG, Galante JO. The progression of patellofemoral arthrosis after medial unicompartmental replacement: results at 11 to 15 years. Clin Orthop Relat Res. 2004;428:92–99.PubMedCrossRef
6.
Zurück zum Zitat Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, Galante JO. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res. 1999;367:50–60.PubMedCrossRef Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, Galante JO. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res. 1999;367:50–60.PubMedCrossRef
7.
Zurück zum Zitat Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty. 1996;11:782–788.PubMedCrossRef Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty. 1996;11:782–788.PubMedCrossRef
8.
Zurück zum Zitat Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989;248:9–12.PubMed Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989;248:9–12.PubMed
9.
Zurück zum Zitat Gioe TJ, Killeen KK, Hoeffel DP, Bert JM, Comfort TK, Scheltema K, Mehle S, Grimm K. Analysis of unicompartmental knee arthroplasty in a community-based implant registry. Clin Orthop Relat Res. 2003;416:111–119.PubMedCrossRef Gioe TJ, Killeen KK, Hoeffel DP, Bert JM, Comfort TK, Scheltema K, Mehle S, Grimm K. Analysis of unicompartmental knee arthroplasty in a community-based implant registry. Clin Orthop Relat Res. 2003;416:111–119.PubMedCrossRef
10.
Zurück zum Zitat Hernigou P, Deschamps G. Patellar impingement following unicompartmental arthroplasty. J Bone Joint Surg Am. 2002;84:1132–1137.PubMed Hernigou P, Deschamps G. Patellar impingement following unicompartmental arthroplasty. J Bone Joint Surg Am. 2002;84:1132–1137.PubMed
11.
Zurück zum Zitat Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980;62:1329–1337.PubMed Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980;62:1329–1337.PubMed
12.
Zurück zum Zitat Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58:754–765.PubMed Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am. 1976;58:754–765.PubMed
13.
Zurück zum Zitat Khan OH, Davies H, Newman JH, Weale AE. Radiological changes ten years after St Georg Sled unicompartmental knee replacement. Knee. 2004;11:403–407.PubMedCrossRef Khan OH, Davies H, Newman JH, Weale AE. Radiological changes ten years after St Georg Sled unicompartmental knee replacement. Knee. 2004;11:403–407.PubMedCrossRef
14.
Zurück zum Zitat Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79:499–507.PubMedCrossRef Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79:499–507.PubMedCrossRef
15.
Zurück zum Zitat Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V. Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007;78:128–135.PubMedCrossRef Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V. Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007;78:128–135.PubMedCrossRef
16.
Zurück zum Zitat Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am. 1989;71:145–150.PubMed Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am. 1989;71:145–150.PubMed
17.
Zurück zum Zitat Lachiewicz PF, Soileau ES. Fifteen-year survival and osteolysis associated with a modular posterior stabilized knee replacement. A concise follow-up of a previous report. J Bone Joint Surg Am. 2009;91:1419–1423.PubMedCrossRef Lachiewicz PF, Soileau ES. Fifteen-year survival and osteolysis associated with a modular posterior stabilized knee replacement. A concise follow-up of a previous report. J Bone Joint Surg Am. 2009;91:1419–1423.PubMedCrossRef
18.
Zurück zum Zitat Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs fixed bearing unicondylar knee arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13:365–370.PubMedCrossRef Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs fixed bearing unicondylar knee arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13:365–370.PubMedCrossRef
19.
Zurück zum Zitat Lindstrand A, Stenstrom A, Lewold S. Multicenter study of unicompartmental knee revision. PCA, Marmor, and St Georg compared in 3777 cases of arthrosis. Acta Orthop Scand. 1992;63:256–259.PubMedCrossRef Lindstrand A, Stenstrom A, Lewold S. Multicenter study of unicompartmental knee revision. PCA, Marmor, and St Georg compared in 3777 cases of arthrosis. Acta Orthop Scand. 1992;63:256–259.PubMedCrossRef
20.
Zurück zum Zitat Marmor L. Marmor modular knee in unicompartmental disease. Minimum four-year follow-up. J Bone Joint Surg Am. 1979;61:347–353.PubMed Marmor L. Marmor modular knee in unicompartmental disease. Minimum four-year follow-up. J Bone Joint Surg Am. 1979;61:347–353.PubMed
21.
Zurück zum Zitat Marmor L. Unicompartmental arthroplasty of the knee with a minimum ten-year follow-up period. Clin Orthop Relat Res. 1988;228:171–177.PubMed Marmor L. Unicompartmental arthroplasty of the knee with a minimum ten-year follow-up period. Clin Orthop Relat Res. 1988;228:171–177.PubMed
22.
Zurück zum Zitat Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop. 2010;34:1137–1143.PubMedCrossRef Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop. 2010;34:1137–1143.PubMedCrossRef
23.
Zurück zum Zitat Murray DW, Goodfellow JW, O’Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br. 1998;80:983–989.PubMedCrossRef Murray DW, Goodfellow JW, O’Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br. 1998;80:983–989.PubMedCrossRef
24.
Zurück zum Zitat 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;91:52–57.PubMed 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;91:52–57.PubMed
25.
Zurück zum Zitat O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, Sullivan PM, Johnston RC. The John Insall Award: unicompartmental knee replacement: a minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res. 2005;440:27–37.PubMedCrossRef O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, Sullivan PM, Johnston RC. The John Insall Award: unicompartmental knee replacement: a minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res. 2005;440:27–37.PubMedCrossRef
26.
Zurück zum Zitat Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961;43:752–757.PubMed Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961;43:752–757.PubMed
27.
Zurück zum Zitat Parratte S, Argenson JN, Pearce O, Pauly V, Auquier P, Aubaniac JM. Medial unicompartmental knee replacement in the under-50 s. J Bone Joint Surg Br. 2009;91:351–356.PubMedCrossRef Parratte S, Argenson JN, Pearce O, Pauly V, Auquier P, Aubaniac JM. Medial unicompartmental knee replacement in the under-50 s. J Bone Joint Surg Br. 2009;91:351–356.PubMedCrossRef
28.
Zurück zum Zitat Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am. 2003;85:1968–1973.PubMed Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am. 2003;85:1968–1973.PubMed
29.
Zurück zum Zitat Peters PC Jr, Engh GA, Dwyer KA, Vinh TN. Osteolysis after total knee arthroplasty without cement. J Bone Joint Surg Am. 1992;74:864–876.PubMed Peters PC Jr, Engh GA, Dwyer KA, Vinh TN. Osteolysis after total knee arthroplasty without cement. J Bone Joint Surg Am. 1992;74:864–876.PubMed
30.
Zurück zum Zitat Price AJ, Dodd CA, Svard UG, Murray DW. Oxford medial unicompartmental knee arthroplasty in patients younger and older than 60 years of age. J Bone Joint Surg Br. 2005;87:1488–1492.PubMedCrossRef Price AJ, Dodd CA, Svard UG, Murray DW. Oxford medial unicompartmental knee arthroplasty in patients younger and older than 60 years of age. J Bone Joint Surg Br. 2005;87:1488–1492.PubMedCrossRef
31.
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
32.
Zurück zum Zitat Rees JL, Price AJ, Lynskey TG, Svard UC, Dodd CA, Murray DW. Medial unicompartmental arthroplasty after failed high tibial osteotomy. J Bone Joint Surg Br. 2001;83:1034–1036.PubMedCrossRef Rees JL, Price AJ, Lynskey TG, Svard UC, Dodd CA, Murray DW. Medial unicompartmental arthroplasty after failed high tibial osteotomy. J Bone Joint Surg Br. 2001;83:1034–1036.PubMedCrossRef
33.
Zurück zum Zitat Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty. 2008;23:408–412.PubMedCrossRef Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty. 2008;23:408–412.PubMedCrossRef
34.
Zurück zum Zitat Robertsson O, Borgquist L, Knutson K, Lewold S, Lidgren L. 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 prostheses. Acta Orthop Scand. 1999;70:170–175.PubMedCrossRef Robertsson O, Borgquist L, Knutson K, Lewold S, Lidgren L. 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 prostheses. Acta Orthop Scand. 1999;70:170–175.PubMedCrossRef
35.
Zurück zum Zitat Schneider R, Freiberger RH, Ghelman B, Ranawat CS. Radiologic evaluation of painful joint prostheses. Clin Orthop Relat Res. 1982;170:156–168.PubMed Schneider R, Freiberger RH, Ghelman B, Ranawat CS. Radiologic evaluation of painful joint prostheses. Clin Orthop Relat Res. 1982;170:156–168.PubMed
36.
Zurück zum Zitat Scott RD, Cobb AG, McQueary FG, Thornhill TS. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res. 1991;271:96–100.PubMed Scott RD, Cobb AG, McQueary FG, Thornhill TS. Unicompartmental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res. 1991;271:96–100.PubMed
37.
Zurück zum Zitat Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC. Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop Relat Res. 1999;367:61–72.PubMedCrossRef Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC. Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop Relat Res. 1999;367:61–72.PubMedCrossRef
38.
Zurück zum Zitat Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH. Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br. 2006;88:1164–1168.PubMedCrossRef Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH. Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br. 2006;88:1164–1168.PubMedCrossRef
39.
Zurück zum Zitat Svard UC, Price AJ. Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br. 2001;83:191–194.PubMedCrossRef Svard UC, Price AJ. Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br. 2001;83:191–194.PubMedCrossRef
40.
Zurück zum Zitat 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. 1994;302:134–137.PubMed 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. 1994;302:134–137.PubMed
Metadaten
Titel
Long-term Survivorship and Failure Modes of Unicompartmental Knee Arthroplasty
verfasst von
Jared R. H. Foran, MD
Nicholas M. Brown, MD
Craig J. Della Valle, MD
Richard A. Berger, MD
Jorge O. Galante, MD
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 1/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2517-y

Weitere Artikel der Ausgabe 1/2013

Clinical Orthopaedics and Related Research® 1/2013 Zur Ausgabe

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Determinants of Direct Medical Costs in Primary and Revision Total Knee Arthroplasty

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Durability of a Cruciate-retaining TKA With Modular Tibial Trays at 20 Years

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.