Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty.

The investigators reviewed 245 fixed-bearing unicondylar arthroplasties that one surgeon performed as treatment of medial compartment osteoarthritis between 1988 and 1997 using a variety of cemented metal-backed tibial components and gamma-irradiated-in-air polyethylene bearings. Multivariate statistical analysis was used to evaluate how the event of revision was influenced by 3 patient factors, 3 implant factors, and 7 factors assessed from preoperative and early postoperative radiographs. Five factors were statistically associated with revision: (younger) patient age, (thinner) tibial component initial thickness, (longer) polyethylene shelf age, (lesser) angular reduction of medial tibial plateau varus, and (more varus) postoperative hip-knee-ankle angle. Besides illustrating deleterious consequences of using gamma-irradiated-in-air polyethylene in medial unicompartmental arthroplasty, our results support reducing varus angulation of the medial tibial plateau and knee at surgery.

[1]  T. Thornhill,et al.  Unicompartmental knee arthroplasty in middle-aged patients: a 2- to 6-year follow-up evaluation. , 1998, The Journal of arthroplasty.

[2]  R. Emerson,et al.  Comparison of a Mobile With a Fixed-Bearing Unicompartmental Knee Implant , 2002, Clinical orthopaedics and related research.

[3]  L. Marmor.  Unicompartmental arthroplasty of the knee with a minimum ten-year follow-up period. , 1988, Clinical orthopaedics and related research.

[4]  S. Stulberg,et al.  The natural history of unicompartmental arthroplasty. An eight-year follow-up study with survivorship analysis. , 1993, Clinical orthopaedics and related research.

[5]  K Knutson,et al.  The Swedish Knee Arthroplasty Register 1975-1997: An update with special emphasis on 41,223 knees operated on in 1988-1997 , 2001, Acta orthopaedica Scandinavica.

[6]  R. Scott,et al.  Unicondylar knee arthroplasty. , 1989, The Journal of bone and joint surgery. American volume.

[7]  T. Thornhill,et al.  Unicompartmental total knee arthroplasty. , 1989, The Orthopedic clinics of North America.

[8]  R. Scott,et al.  Duplication of medial erosion in unicompartmental knee arthroplasties. , 1995, The Journal of bone and joint surgery. British volume.

[9]  R. White,et al.  Unicompartmental arthroplasty of the knee. Postoperative alignment and its influence on overall results. , 1987, Clinical orthopaedics and related research.

[10]  D. Heck,et al.  Unicompartmental knee arthroplasty. A multicenter investigation with long-term follow-up evaluation. , 1993, Clinical orthopaedics and related research.

[11]  R. Bourne,et al.  Medial unicompartmental knee arthroplasty with the Miller-Galante prosthesis. , 2004, The Journal of bone and joint surgery. American volume.

[12]  J. Galante,et al.  Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. , 2005, The Journal of bone and joint surgery. American volume.

[13]  Donald W Pennington,et al.  Unicompartmental knee arthroplasty in patients sixty years of age or younger. , 2003, The Journal of bone and joint surgery. American volume.

[14]  A. Lindstrand,et al.  Multicenter study of unicompartmental knee revision. PCA, Marmor, and St Georg compared in 3,777 cases of arthrosis. , 1992, Acta orthopaedica Scandinavica.

[15]  Gerard A Engh,et al.  Rapid Polyethylene Failure of Unicondylar Tibial Components Sterilized with Gamma Irradiation in Air and Implanted After a Long Shelf Life , 2002, The Journal of bone and joint surgery. American volume.

[16]  C. Engh,et al.  Shelf age of the polyethylene tibial component and outcome of unicondylar knee arthroplasty. , 2004, The Journal of bone and joint surgery. American volume.

[17]  P. Hernigou,et al.  Alignment Influences Wear in the Knee after Medial Unicompartmental Arthroplasty , 2004, Clinical orthopaedics and related research.

[18]  R. Scott,et al.  Revision of failed unicondylar unicompartmental knee arthroplasty. , 1987, The Journal of bone and joint surgery. American volume.

[19]  H. Tsumura,et al.  Three‐dimensional finite element analysis of unicompartmental knee arthroplasty–the influence of tibial component inclination , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  Joanne B. Adams,et al.  Early Failure of Minimally Invasive Unicompartmental Knee Arthroplasty Is Associated with Obesity , 2005, Clinical orthopaedics and related research.

[21]  R. Scott,et al.  Unicompartmental knee arthroplasty. , 2001, Instructional course lectures.

[22]  K Knutson,et al.  The routine of surgical management reduces failure after unicompartmental knee arthroplasty. , 2001, The Journal of bone and joint surgery. British volume.

[23]  T. Gioe,et al.  Analysis of unicompartmental knee arthroplasty in a community-based implant registry. , 2003, Clinical orthopaedics and related research.

[24]  L Marmor,et al.  The Modular (Marmor) knee: case report with a minimum follow-up of 2 years. , 1976, Clinical orthopaedics and related research.

[25]  S. Toksvig-Larsen,et al.  The introduction period of unicompartmental knee arthroplasty is critical: a clinical, clinical multicentered, and radiostereometric study of 251 Duracon unicompartmental knee arthroplasties. , 2000, The Journal of arthroplasty.

[26]  T. Perkins,et al.  Unicompartmental knee arthroplasty: 3- to 10-year results in a community hospital setting. , 2002, The Journal of arthroplasty.

[27]  Gerard Deschamps,et al.  Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. , 2004, The Journal of bone and joint surgery. American volume.

[28]  S. Stulberg,et al.  Polyethylene wear in unicompartmental knee arthroplasty. , 1994, Clinical orthopaedics and related research.

[29]  J. Aubaniac,et al.  Modern Unicompartmental Knee Arthroplasty with Cement: A Three to Ten-Year Follow-up Study , 2002, The Journal of bone and joint surgery. American volume.

[30]  S. Palmer,et al.  Early Catastrophic Tibial Component Wear After Unicompartmental Knee Arthroplasty , 1998, Clinical orthopaedics and related research.