Abstract
IntroductionThe surgical technique used in unicompartmental knee arthroplasty (UKA) is crucial for achieving good short and long term clinical outcomes. The medial mobile bearing UKA has shown excellent clinical outcomes and survivorship. But release of the medial collateral ligament during entering joint is cause of mobile bearing dislocation in short term outcomes and lateral compartment osteoarthritis may occur in the mid to long term outcomes. Removing all osteophytes at the time of UKA is sometime impossible due to their large size and extend to the inferior part of medial tibial plateau and removing them completely my result in release of the MCL. But no data exist on clinical outcomes in such patients.MethodsWe conducted a prospective study from 2010 to 2015 of patients undergoing mobile bearing UKA and classified them in to two groups: those with (Gp1) and without (Gp2) residual osteophytes. Osteophyte size was measured using Hernborg’s technique. The primary outcomes were pain score, functional score, and knee scores and the presence of reported medial knee pain.Results176 patients who underwent 199 mobile bearing UKAs were recruited: Gp1 = 42 patients (46 knees) and Gp2 = 134 patients (153 knees). Residual osteophyte sizes ranged from 2.13–9.42 mm (mean 4.12). The mean Gp1 Gp2 pain score (49.04, 48.92, p = 0.84), functional score (83.75, 84.04, p = 0.83) and knee score (89.86, 98.7, p = 0.0.78) scores were almost identical and no one complained of medial joint pain. Followed up ranged from 2 − 7 years (mean 4.23). No patients were lost to follow up.ConclusionThe patients with residual osteophytes of length less than 9 mm had good and similar clinical outcomes as patients without residual osteophytes following mobile bearing UKA.Level of evidenceLevel II-2, evidence obtained from well-designed cohort studies or case-control studies, preferably from more than one center or research group.
Highlights
The surgical technique used in unicompartmental knee arthroplasty (UKA) is crucial for achieving good short and long term clinical outcomes
Surgical technique is important for outcomes in unicompartmental knee arthroplasty (UKA)
Some patients have large osteophytes that extend to the inferior part of medial tibial plateau [10,11] and removing them completely may result in release of the medial collateral ligament (MCL)
Summary
The surgical technique used in unicompartmental knee arthroplasty (UKA) is crucial for achieving good short and long term clinical outcomes. The medial mobile bearing UKA has shown excellent clinical outcomes and survivorship. Release of the medial collateral ligament during entering joint is cause of mobile bearing dislocation in short term outcomes and lateral compartment osteoarthritis may occur in the mid to long term outcomes. Removing all osteophytes at the time of UKA is sometime impossible due to their large size and extend to the inferior part of medial tibial plateau and removing them completely my result in release of the MCL. No data exist on clinical outcomes in such patients
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