Abstract
BackgroundUnicompartmental knee arthroplasty (UKA) treats arthritis involving only one compartment of the knee. Lateral UKA is mainly performed through medial parapatellar or lateral parapatellar approaches to the knee. This technique article introduces a medial subvastus approach to lateral UKA, discusses the clinical rationale behind its use, and offers a preliminary retrospective study on short-term outcomes of lateral UKAs using the lateral vs medial subvastus approaches. MethodsA description of the medial subvastus approach is included. In addition, we reviewed 32 and 30 lateral UKAs performed using the lateral and medial subvastus approaches, respectively. Minimum follow-up duration was 1 year. Knee injury and osteoarthritis outcome score for joint replacement (KOOS, JR) knee scores were used for comparison. ResultsAge and body mass index were similar between the 2 cohorts. Mean KOOS, JR. scores for the subvastus approach group were significantly higher than those for the lateral approach group at 81.41 ± 2.0 for medial subvastus and 74.19 ± 2.9 for lateral (P = .02). One deep infection and 2 revision total knee arthroplasties occurred in the lateral approach group. Neither occurred in the subvastus group. The mean follow-up duration was significantly longer for the lateral approach group than that for the subvastus group at 749 vs 410 days (P < .001). Literature on time-dependence of patient-reported outcomes supports usage of the data, despite follow-up discrepancies. ConclusionsA subvastus approach for lateral UKA may offer improved visualization, easier conversion to total knee arthroplasty, and faster recovery, based on clinical observation. Preliminary results suggest improved short-term knee scores compared to a lateral approach.
Highlights
Total knee arthroplasty is a very common and successful operative intervention to treat arthritis of the knee
Many surgeons have turned to unicompartmental knee replacement (UKA) to treat patients with arthritis involving only one of the 3 compartments of the knee
Lateral compartment degenerative joint disease and lateral partial knee replacement comprise less than 1% of all knee
Summary
Total knee arthroplasty is a very common and successful operative intervention to treat arthritis of the knee. Many surgeons have turned to unicompartmental knee replacement (UKA) to treat patients with arthritis involving only one of the 3 compartments of the knee. The senior author switched from using lateral parapatellar approach to the novel medial subvastus technique in a high-volume joint replacement practice based off of his own clinical considerations. This technique article aims to explain the medial subvastus approach for lateral unicompartmental knee arthroplasty, as well as to offer a retrospective, exploratory study comparing short-term patient-reported outcomes of lateral UKAs performed through the medial subvastus and lateral approaches. Conclusions: A subvastus approach for lateral UKA may offer improved visualization, easier conversion to total knee arthroplasty, and faster recovery, based on clinical observation.
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