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Fixed bearing, all-polyethylene tibia, lateral unicompartmental arthroplasty – A final outcome study with up to 28 year follow-up of a single implant

Murray, James R.D.; Smith, James R.A.; Bray, Rachel; Robinson, James R.; White, Paul; Porteous, Andrew J.

Authors

James R.D. Murray

James R.A. Smith

Rachel Bray

James R. Robinson

Paul White Paul.White@uwe.ac.uk
Professor in Applied Statistics

Andrew J. Porteous



Abstract

Background: Lateral unicompartmental arthroplasty (UKA) constitutes only 5–10% of all unicompartmental replacements performed. Whilst the short and medium term benefits are well documented, there remains concern regarding the higher revision rate when compared with total knee replacement. We report the long term clinical outcome and survivorship of a large series of lateral UKA. Patients and Methods: Between 1974 and 1994, 71 patients (82 knees) underwent a lateral fixed-bearing St Georg Sled UKA. Prospective data was collected pre-operatively and at regular intervals post-operatively using the Bristol Knee Score (BKS), with later introduction of the Oxford Knee (OKS) and Western Ontario MacMaster (WOMAC) scores. Kaplan Meier survival analysis was used, with revision, or need for revision, as end point. 85% of the patients were female. No patients were lost to follow-up. Results: Functional knee scores improved post-operatively up to 10 years, at which point they demonstrated a steady decline. Survivorship was 72% at 15 years, and 68% at 20 and 25 years. Nineteen knees were revised, with progression of disease in another compartment the commonest reason. There were two revisions due to implant fracture. In patients aged over 70 years at time of index procedure, 81% died with a functioning prosthesis in situ. Conclusion: This represents the longest follow-up of a large series of lateral UKA. Results of this early design of fixed bearing UKA demonstrate satisfactory long term survivorship. In elderly patients, further intervention is rarely required. More contemporary designs or techniques may show improved long term survivorship in time.

Citation

Murray, J. R., Smith, J. R., Bray, R., Robinson, J. R., White, P., & Porteous, A. J. (2021). Fixed bearing, all-polyethylene tibia, lateral unicompartmental arthroplasty – A final outcome study with up to 28 year follow-up of a single implant. Knee, 29, 101-109. https://doi.org/10.1016/j.knee.2020.12.032

Journal Article Type Article
Acceptance Date Dec 29, 2020
Online Publication Date Feb 17, 2021
Publication Date Mar 1, 2021
Deposit Date Jan 10, 2021
Publicly Available Date Mar 29, 2024
Journal The Knee
Print ISSN 0968-0160
Electronic ISSN 1873-5800
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 29
Pages 101-109
DOI https://doi.org/10.1016/j.knee.2020.12.032
Public URL https://uwe-repository.worktribe.com/output/6979564

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