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.