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We have previously reported in 57 patients (60 hips) with a past history of Legg-Calvé-Perthes’ disease at a mean of 34 years after the onset of symptoms. From this original group, 48 patients (51 hips) were also available for review after a mean of 50.2 years. We consider that the best prognostic indicator for the hip is the shape of the femoral head at skeletal maturity. Normal or flattened spherical heads present few problems. Irregular or very irregular heads are associated with a poor outcome.

One hundred and one unicompartmental knee arthroplasties (UKA) were done between 1996 and 2000 with ALPINA(®) UNI, a cementless hydroxyapatite-coated anatomic prosthesis. Sixty-five knees were available for the long-term follow-up at a mean of 11 years. The mean IKS improved from 119.3 ± 16.8 points preoperatively to 171.4 ± 25.3 at the latest follow-up (p < 0.0001). Eighty-nine percentage of the knees were rated good and excellent. The mean knee flexion has significantly improved from 120°5 preoperatively to 127°3 at the latest follow-up (p < 0.01). Eleven revision procedures were done: 1 for early knee degeneration on rheumatoid arthritis, 1 for degeneration of osteoarthritis in the opposite compartment of the knee, 1 for unexplained pain and 1 for late ACL rupture, all these 4 cases were replaced by total knee arthroplasties; 3 revisions by another UKA were done due to polyethylene insert fracture; and 4 partial revision were done for bearing exchange due to severe polyethylene wear. When revision for any reason was defined as the end point, the 13-year Kaplan-Meier survival rate was 88 % (95 % CI 81-95 %) and when revision due to implant mechanical failure (excluding degeneration of osteoarthritis in the opposite compartment of the knee and bearing exchange only) was defined as the end point, the 13-year survival rate was 94 % (95 % CI 89.1-99.1 %).

Twenty-two patients who received primary unicompartmental knee arthroplasties (21 medial and 1 lateral) were reoperated between 2001 and 2010 for partial or total replacement of their implant without using a TKA. Of the 21 patients (1 bilateral) reoperated for PE insert wear (11), PE fracture (3), infection (2), and loosening or malposition (6), 3 patients died and 2 were lost to follow up. The remaining 17 cases had their clinical scores significantly improved. Only one re-revision occurred and consisted of a simple change of PE insert at 9 years, on a very heavy and very active patient. It therefore seems possible and reasonable for now to continue partial or total replacement of unicompartmental knee arthroplasty by another unicompartmental knee arthroplasty without using a TKA.