Abstract
In 1972, unicondylar arthroplasty (UKA) was introduced, along with total knee arthroplasty (TKA), as an option for managing gonarthrosis. Although the early clinical results with the first generation of implants were equivalent to those of total knee arthroplasty, little interest in UKA was sustained. If unicondylar arthroplasty is to realise a role in the management of degenerative arthritis, even as a temporising procedure, the results must be predictable and reproducible. Patient satisfaction must be equivalent to or better than that of TKA. Finally, the conversion of UKA to TKA must be uncomplicated, avoiding complex reconstructive procedures and the use of revision implants.
UKA achieves these goals. As documented by such things as reduced blood loss and risk of infection, morbidity has always been less with unicondylar arthroplasty. Patients with both a UKA and a TKA on the contralateral side generally prefer the unicondylar knee. This is partly because a UKA provides a superior range of motion and better function with such activities as stair climbing. Adapting the surgery to an outpatient operative procedure using a minimally invasive incision has enhanced patient satisfaction.
In most studies, the revision of a failed unicondylar arthroplasty using primary TKA components has been predictable and durable. Osteolysis has not been reported with failed UKA; therefore bone defects usually are minimal. If major tibial bone defects are present, a revision tibial component and proper bone defect management will achieve excellent results.
In conclusion, we cannot only justify UKA as a temporising procedure, but also as a definitive procedure with long-term results that are comparable to TKA for gonarthrosis.
The abstracts were prepared by Mrs Dorothy L. Granchi, Course Coordinator. Correspondence should be addressed to her at PMB 295, 8000 Plaza Boulevard, Mentor, Ohio 44060, USA.
