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Patients gained added range of motion after lateral partial knee replacement
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ORLANDO — Lateral unicompartmental knee replacement, when used in patients who meet certain key indications, such as having isolated lateral bone-on-bone arthritis, can be a viable treatment option for isolated lateral compartment disease, based on data presented at the Current Concepts in Joint Replacement Winter Meeting.
Michael E. Berend, MD, of Midwest Center for Joint Replacement in Indianapolis, said the isolated bone-on-bone diagnosis is often missed “as it is a disease of flexion.” Therefore, he recommended getting flexed posterior-anterior views in patients who are potential candidates for lateral partial knee replacement (PKR), which he described as an emerging procedure.
“This now represents 4% of all of our knee arthroplasties —these are lateral partial knees,” Berend said.
“The algorithm is actually this: Take out the diseased tissue and leave the normal tissue behind. That’s it, and it applies to the lateral compartment, as well,” he said.
To make his case about this procedure as an alternative to total knee replacement, Berend presented results of a consecutive series of about 3,500 knees that included medial PKR and TKR cases, as well as 147 fixed-bearing lateral PKRs done via a lateral parapatellar arthrotomy in patients whose average age was 66 years.
At 1.3 years average follow-up, Knee Society Scores in the patients with lateral PKR, which were 41 points preoperatively, improved to 86 points postoperatively. The patients who underwent lateral PKR also gained additional range of motion, according to the results.
Preoperative range of motion of 6° degrees to 113° improved to 0° to 123° postoperatively.
There was “predictable improvement in clinical range of motion, including flexion contracture,” Berend said.
Furthermore, he said revision rates in this lateral PKR series were “acceptable.”
“It adds predictable, early pain relief and excellent range of motion,” Berend said. – by Susan M. Rapp
Reference:
Berend ME. Paper 73. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 12-15, 2018; Orlando.
Disclosure: Berend reports he receives royalties for development from Innomed and Zimmer Biomet; he receives equity from Promapp Software; he receives consulting for speaking and teaching from Zimmer Biomet; and he receives royalties from Zimmer Biomet.