Unicompartmental knee arthroplasty yields high survivorship at 15 years

DALLAS — Younger patients with unicompartmental arthritis experienced improvements in functional outcomes and high survivorship at 15 years after undergoing unicompartmental knee arthroplasty, according to a poster presented at the American Association of Hip and Knee Surgeons Annual Meeting.

Yale A. Fillingham, MD, and colleagues measured clinical outcomes among 82 medial unicompartmental knee arthroplasties in 40 men and 31 women with a mean age of 50.7 years using the Knee Society Score and assessed radiographs for component loosening, wear and arthritic progression in the unresurfaced compartments.

Overall, 92.4% of patients were available for follow-up at a mean of 10.5 years. Results showed improvement in Knee Society Score functional score from 59.3 points preoperatively to 85.5 points postoperatively. At a mean of 55.7 months postoperatively, researchers noted eight knees underwent revision to a total knee arthroplasty, including three for unexplained pain, three for adjacent compartment degeneration, one for full thickness polyethylene wear and breakage of the femoral component and one for polyethylene wear and lateral compartment degeneration. At 15 years, patients had an estimated survivorship with failure for any reason of 86.7%, according to results. Researchers found arthritis progression to grade 1 or grade 2 in an adjacent compartment in 81% of patients, while 25% of patients had progression to grade 3 or grade 4 at a mean of 8.9 years.

“We’ve often been hesitant to look towards arthroplasty as an option for the young active patient with unicompartmental disease. Historically an osteotomy has been viewed as the work-horse for these young active patients, but we’ve shown at 15 years unicompartmental knee arthroplasties are holding up very well overtime,” Fillingham told Healio.com/Orthopedics. “Unicompartmental arthroplasty should be strongly considered for the young active patient with unicompartmental disease.” – by Casey Tingle

Reference:

Hannon CP, et al. Poster 97. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 1-4, 2018; Dallas.

Disclosure: Fillingham reports he is a paid consultant for Johnson & Johnson.