My orthopaedic surgeon suggests a unicompartmental knee replacement: a detailed look at the long-term outcomes of a single surgeon's practice.

Abstract

This single surgeon case series with up to 29-year follow-up evaluated the survival of the Oxford unicompartmental knee replacement (UKR) for isolated medial compartment osteoarthritis. Four hundred and four knees in 330 patients were followed for between 12 days to 29 years, with an average of 13 years. Kaplan-Meier survival estimates were calculated using revision for total knee replacement and re-operation for any reason over 5-year intervals. Revision and reoperation rates per 100 component years were used to compare subsets, cemented and uncemented prostheses and Phase 2 and Phase 3 instrumentation. Of 404 UKRs, 292 (72%) were cemented, 96 (24%) uncemented and 16 hybrid (4%); 137 (34%) were undertaken using Phase 2 instrumentation and 267 (66%) Phase 3 instrumentation. Estimated revision-free implant survival at 20 years was 78%, and estimated reoperation-free survival at 20 years was 72%. Unicompartmental knee replacement is a very successful procedure, with 78% of knees remaining revision-free at 20 years. Progression of lateral compartment arthritis was the most common cause for revision, affecting 60% of revision cases. There was no significant difference in the revision or reoperation rate between cemented and uncemented prostheses or Phase 2 and minimally invasive Phase 3 instrumentation.