Abstract
Aim: To study of the results of the first 100 Miller-Galante, unicompartmental knee replacements performed by one surgeon over the period from May 1990 to November 1996, with particular reference to the failure mechanisms.
Method: A cohort of 100 patients has been followed up prospectively on a biennial basis. They have been assessed using the Nottingham Knee Proforma of Tew & Waugh. An up-dated review was carried out of the cases for the preparation of this presentation.
Results:
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Alive, knee functioning satisfactorily – 57
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Dead, knee functioning satisfactorily – 21
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Lost to follow up – 10
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Significant symptoms, not revised – 2
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Infection – 1 case not requiring revision
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Revised – 9
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Due for revision – 1
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Of the 32 patients over the age of 74 at the time of replacement none have required revision (18 still alive).
Reasons for revision:
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6 developed degeneration in another compartment
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2 had unexplained pain
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1 developed loosening of the tibial component (19 components found to be well fixed to bone at revision)
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1 developed significant wear and is due for revision
Conclusions: This prosthesis remains a surgical option for treatment of unicompartmental knee osteoarthrosis. As judged on survival it appears to be superior to high tibial osteotome (HTO) but it appears to be inferior to total knee replacement (TKR). It is easier to revise than failed HTO or TKR. Careful patient selection is obviously required.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
