David J Bruce1, Mohammed Hassaballa2, James R Robinson2, Andrew J Porteous3, James R Murray4, John H Newman2. 1. Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK. Electronic address: David.bruce7@nhs.net. 2. Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK. 3. Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK. Electronic address: Andrew.porteous@nbt.nhs.uk. 4. Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK. Electronic address: james.murray@doctors.org.uk.
Abstract
BACKGROUND: Unicompartmental knee arthroplasty (UKA) accounts for 8.9% of knee arthroplasty procedures in England, Wales and Northern Ireland. Fixed bearing UKA designs have shown favourable survivorship in registries when compared with mobile bearings but some studies suggest poor survival of all-polyethylene fixed tibial bearings. This study analyses long-term follow-up of patients with a medial fixed all-polyethylene tibial bearing UKA and reports survivorship and 10-year clinical outcomes. METHODS: Data was collected prospectively for 214 medial unicompartmental all-polyethylene tibial bearing UKAs implanted in 184 patients at our tertiary referral centre between November 2002 and December 2007. The indication was osteoarthritis in all but one patient. Patient reported outcome scores were documented pre-operatively and at five, eight, 10 and 12 years of follow-up. The mean patient age was 70 years (range 41-87). RESULTS: Outcome and survivorship data were collected for 214 medial all-polyethylene tibial bearing UKAs. There were outcomes recorded for 83 UKAs with at least 10-year follow-up. Twenty-four patients underwent revision of their UKA at an average of 5.84 years after the primary procedure. Kaplan-Meier analysis demonstrated survivorship of 89.1% at 10 years and the OKS, AKSS and WOMAC patient reported outcomes remained significantly improved in comparison to preoperatively. For those 70 years or older, 10-year survivorship was 92.4%, compared to 85.0% for those under 70 years old. CONCLUSION: Medial fixed all-polyethylene tibial bearing UKA demonstrates acceptable long-term survivorship and patient outcomes. It appears to be a suitable option for the treatment of medial compartment OA, particularly in older patients.
BACKGROUND: Unicompartmental knee arthroplasty (UKA) accounts for 8.9% of knee arthroplasty procedures in England, Wales and Northern Ireland. Fixed bearing UKA designs have shown favourable survivorship in registries when compared with mobile bearings but some studies suggest poor survival of all-polyethylene fixed tibial bearings. This study analyses long-term follow-up of patients with a medial fixed all-polyethylene tibial bearing UKA and reports survivorship and 10-year clinical outcomes. METHODS: Data was collected prospectively for 214 medial unicompartmental all-polyethylene tibial bearing UKAs implanted in 184 patients at our tertiary referral centre between November 2002 and December 2007. The indication was osteoarthritis in all but one patient. Patient reported outcome scores were documented pre-operatively and at five, eight, 10 and 12 years of follow-up. The mean patient age was 70 years (range 41-87). RESULTS: Outcome and survivorship data were collected for 214 medial all-polyethylene tibial bearing UKAs. There were outcomes recorded for 83 UKAs with at least 10-year follow-up. Twenty-four patients underwent revision of their UKA at an average of 5.84 years after the primary procedure. Kaplan-Meier analysis demonstrated survivorship of 89.1% at 10 years and the OKS, AKSS and WOMAC patient reported outcomes remained significantly improved in comparison to preoperatively. For those 70 years or older, 10-year survivorship was 92.4%, compared to 85.0% for those under 70 years old. CONCLUSION: Medial fixed all-polyethylene tibial bearing UKA demonstrates acceptable long-term survivorship and patient outcomes. It appears to be a suitable option for the treatment of medial compartment OA, particularly in older patients.