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Medial Unicompartmental Knee Arthroplasty with the Miller-Galante Prosthesis
Douglas Naudie, MD, FRCS(C)1; Jeff Guerin, BMath1; David A. Parker, MBBS, FRACS2; Robert B. Bourne, MD, FRCS(C)1; Cecil H. Rorabeck, MD, FRCS(C)1
1 Division of Orthopaedic Surgery, London Health Sciences Centre—University Campus, University of Western Ontario, 339 Windermere Road, London, Ontario, Canada N6A 5A5. E-mail address for D. Naudie: dnaudie@mac.com
2 Sydney Orthopaedic, Arthritis and Sports Medicine, Level 1, The Gallery, 445 Victoria Avenue, Chatswood, Sydney, Australia 2067. E-mail address: dparker@sydneyortho.com.au
The Journal of Bone & Joint Surgery.  2004; 86:1931-1935 
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Abstract

Background: Unicompartmental knee arthroplasty has become a popular treatment alternative for osteoarthritis that is confined to the medial part of the knee. Excellent intermediate-term results recently have been reported in association with the Miller-Galante unicompartmental implant. The purpose of the present study was to report on our longer-term experience with the Miller-Galante medial unicompartmental knee implant.

Methods: We evaluated the results of 113 medial unicompartmental knee arthroplasties that had been performed with use of the Miller-Galante implant in eighty-four patients between 1989 and 2000. The mean age of the patients at the time of surgery was sixty-eight years. Forty-five patients were men, and thirty-nine were women. Thirteen patients (sixteen knees) died at a mean of seven years after the index arthroplasty. No patient was lost to follow-up. The remaining seventy-one patients (ninety-seven knees) were followed for a mean of ten years and were evaluated with use of the Knee Society clinical and radiographic rating system.

Results: Eleven knees were revised at a mean of four years after the index procedure. The mean Knee Society knee and function scores for the sixty-one patients (eighty-six knees) who were living and who had not had a revision improved from 48 and 53 points preoperatively to 93 and 80 points at the time of the most recent evaluation. The five and ten-year rates of survival were 94% and 90%, respectively, with revision to tricompartmental knee arthroplasty as the end point and 93% and 86%, respectively, with revision or radiographic loosening as the end point.

Conclusions: The Miller-Galante medial unicompartmental knee arthroplasty provided excellent pain relief and restoration of function in carefully selected patients and demonstrated durable implant survival at ten years.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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