J Korean Orthop Assoc.  2007 Aug;42(4):515-522. 10.4055/jkoa.2007.42.4.515.

Results of the First Fifty Minimally Invasive OxfordUnicompartmental Knee Arthroplasty

• Song MH
• Kim BH
• Ahn SJ
• Yoo SH
• Park JH

• KMID: 2186514
• DOI: http://doi.org/10.4055/jkoa.2007.42.4.515

Abstract

PURPOSE: To report the advantages and the defects through an analysis of the early results of minimally invasive unicompartmental knee arthroplasty (UKA).
MATERIALS AND METHODS
The first fifty consecutive minimally invasive UKA for medial osteoarthritis that were followed up for at least 2 years (2 years-2 years 10 months) were included. The surgical parameters, clinical parameters, radiological parameters and complications were examined.
RESULTS
The average preoperative knee score was 47.7, which improved to 82.7, 86.7, 87.9 and 89.4 at 6 weeks, 6 months, 1 year and 2 years after surgery, respectively. The average function score was 42.2, which improved to 71.5, 77.4, 81.3 and 84.7 at the 6 weeks, 6 months, 1 year and 2 years follow up, respectively. The average range of knee motion was 124.6 degrees preoperatively, which changed to 128.4 degrees, 134.2 degrees, 136.8 degrees and 138.5 degrees at 6 weeks, 6 months, 1 year and 2 years, respectively. The preoperative tibiofemoral angle was 2.5 degrees of varus, which changed to 3.4 degrees of valgus postoperatively. Three revisions to total knee arthroplasty were performed due to two fractures of the medial tibial condyle and one dislocation of the femoral component.
CONCLUSION
The early postoperative results of minimally invasive UKA showed satisfactory improvement in the knee score, function score and recovery of the range of motion. However, surgeons must be aware of the severe complications that require a revision procedure.

Keyword

Knee joint; Osteoarthritis; Unicompartmental knee arthroplasty

MeSH Terms

Arthroplasty*
Dislocations
Follow-Up Studies
Knee Joint
Knee*
Osteoarthritis
Range of Motion, Articular

Figure

• 

  Fig. 1 The small skin incision along the medial side of the patella tendon.

Reference

1. Barrett WP, Scott RD. Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Joint Surg Am. 1987. 69:1328–1335.

2. Berger RA, Nedeff DD, Barden RM, et al. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res. 1999. 367:50–60.

3. Brumby SA, Carrington R, Zayontz S, Reish T, Scott RD. Tibial plateau stress fracture: a complication of unicompartmental knee arthroplasty using 4 guide pinholes. J Arthroplasty. 2003. 18:809–812.

4. Goodfellow J, O'Connor J. The mechanics of the knee and prosthesis design. J Bone Joint Surg Br. 1978. 60:358–369.

5. Hopgood P, Martin CP, Rae PJ. The effect of tibial implant size on post-operative alignment following medial unicompartmental knee replacement. Knee. 2004. 11:385–388.

6. Insall J, Walker P. Unicondylar knee replacement. Clin Orthop Relat Res. 1976. 120:83–85.

7. Jung YB, Lee YS. Principles of unicompartmental knee arthroplasty. J Korean Orthop Assoc. 2004. 39:108–114.

8. 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.

9. Keys GW, Ul-Abiddin Z, Toh EM. Analysis of first forty Oxford medial unicompartmental knee replacement from a small district hospital in UK. Knee. 2004. 11:375–377.

10. Kim KT, Lee S, Bae EH, Kim HS, Park JS, Cha SG. Unicompartmental knee arthroplasty: a prospective analysis and short-term results. J Korean Orthop Assoc. 2005. 40:161–167.

11. Kim KT, Lee S, Bae EH, Kim HS, Park HS, Park KY. Short-term results and early complications of minimally invasive unicompartmental knee arthroplasty. J Korean Knee Society. 2005. 17:119–126.

12. Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am. 1989. 71:145–150.

13. Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am. 1978. 60:182–185.

14. Lindstrand A, Stenström A, Ryd L, Toksvig-Larsen S. The introduction period of unicompartmental knee arthroplasty is critical: a clinical, clinical multicentered, and radiostereometric study of 251 Duracon unicompartmental knee arthroplasties. J Arthroplasty. 2000. 15:608–616.

15. 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.

16. Price AJ, Webb J, Topf H, et al. Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplasty. 2001. 16:970–976.

17. Rees JL, Price AJ, Beard DJ, Dodd CA, Murray DW. Minimally invasive Oxford unicompartmental knee arthroplasty: functional results at 1 year and the effect of surgical inexperience. Knee. 2004. 11:363–367.

18. Repicci JA, Eberle RW. Minimally invasive surgical technique for unicondylar knee arthroplasty. J South Orthop Assoc. 1999. 8:20–27.

19. Ridgeway SR, McAuley JP, Ammeen DJ, Engh GA. The effect of alignment of the knee on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br. 2002. 84:351–355.

20. Riebel GD, Werner FW, Ayers DC, Bromka J, Murray DG. Early failure of the femoral component in unicompartmental knee arthroplasty. J Arthroplasty. 1995. 10:615–621.

21. Robertsson O, Knutson K, Lewold S, Lidgren L. The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Joint Surg Br. 2001. 83:45–49.

22. Romanowski MR, Repicci JA. Minimally invasive unicondylar arthroplasty: eight-year follow-up. J Knee Surg. 2002. 15:17–22.

23. 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.

24. Song MH, Kim BH, Ahn SJ, Yoo SH, Lee MS. Comparison of midvastus and medial parapatellar approach for total knee arthroplasty. J Korean Orthop Assoc. 2005. 40:902–907.

25. 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.

26. Vardi G, Strover AE. Early complications of unicompartmental knee replacement: the Droitwich experience. Knee. 2004. 11:389–394.

27. Yang KY, Yeo SJ, Lo NN. Stress fracture of the medial tibial plateau after minimally invasive unicompartmental knee arthroplasty: a report of 2 cases. J Arthroplasty. 2003. 18:801–803.