[Long-term results of unicompartmental knee joint replacement].

PURPOSE OF THE STUDY: To evaluate the long-term results of unicompartmental knee joint alloplasty (UKA) in a group of 21 patients. On the basis of their own results and literature data, the authors discuss effective strategies for treatment of unicompartmental osteoarthritis of the knee joint.

MATERIAL: A group of 21 patients, who were implanted a total of 22 unicompartmental knee replacements, type St. Georg, Waldemar Link, between 1986 and 1992, were followed-up till 2002. Since two patients living permanently abroad were excluded, the group at the final evaluation consisted of 19 patients with a total of 20 knee replacements.

METHODS: In 2002, all patients were clinically and radiologically examined. They were interviewed about their subjective evaluation of the knee joint after alloplasty, and clinical and functional findings were assessed. The evaluation of long-term results was based on The Knee Society Clinical Rating System.

RESULTS: The average Knee Score value was 84 points and average Function Score value was 78 points. Out of the 20 knee replacements evaluated, only one failure of UKA was recorded at 9 years after the primary implantation.

DISCUSSION: The authors discuss the current state of treatment in unicompartmental knee arthritis and present several different views based on literature sources. Opinions on indications for specific surgical methods are still controversial. The authors draw attention to comparisons of long-term results between patients with UKA and patients who underwent high tibial valgus osteotomy or total knee replacement. They discuss the advantages and disadvantages of UKA in comparison with the other therapies. They also pay some attention to repeat surgery in failed UKA.

CONCLUSIONS: UKA implantation is a surgical method of managing unicompartmental arthritis of the knee joint. The results presented by the authors and corroborated by many literature data provide evidence that UKA is of great importance in the treatment of unicompartmental knee arthritis. If a consistent selection of patients is maintained, a precise operation technique is used and a reliable implant is chosen, excellent immediate as well as long-term outcomes will be achieved.