The Case for a Fixed-Bearing Unicompartmental Knee Arthroplasty
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First introduced in the 1970’s, the unicompartmental knee arthroplasty did not gain initial widespread acceptance. Early reports by Insall and Aglietti, and Laskin suggested a high failure rate. However these studies included patients who underwent concomitant patellectomy, had inflammatory arthropathy, or who had a very thin (6 mm) tibial polyethylene component1,2. Over the subsequent decade, however, good results were reported for both medial and lateral unicompartmental designs, as the indications for unicompartmental arthroplasty gradually became better defined3,4. Longer follow-up studies have since reported ten-year survival rates without revision for unicompartmental implants ranging from 82% to 98%5-14…
…In summary, unicompartmental knee arthroplasty remains an excellent treatment alternative for osteoarthritis confined to the medial or lateral part of the knee joint. Fixed-bearing implants have been shown to provide good pain relief and restoration of function, and have reproducibly demonstrated excellent survivorship into the second decade. This author makes the case for a fixed-bearing over a mobile-bearing implant because they are technically easier, avoid the complication of bearing dislocation, are more versatile, and less expensive.
Douglas Naudie, M.D., FRCSC
Assistant Professor, University of Western Ontario