Lateral Unicompartmental Knee Arthroplasty Through a Lateral Parapatellar Approach Has High Early Survivorship

Abstract

Background The literature suggests lateral unicompartmental knee arthroplasties are associated with low revision rates. However, there are fewer reports describing techniques for lateral unicompartmental arthroplasty and whether technique influences ROM and function compared to reports for medial unicompartmental arthroplasty.

Survival of medial versus lateral unicompartmental knee arthroplasty: A meta-analysis

“…Improvements in implant materials and design in medial UKA have allowed for more accurate alignment and positioning, which have markedly improved survival and functional outcomes. [21][22][23][24] The results of recent studies have shownthat newly developed lateral UKA systems are shaped appropriately to allow for sliding, rolling, and distracting forces, lowering the rate of dislocations in lateral UKA; [16,25] whereas newly developed implant material and design have not improved survival in medial UKA. Furthermore, all UKA implants have been developed recently, and there is no single uniform implant.…”

The Current Trends for Lateral Unicondylar Knee Arthroplasty

“…Isolated medial compartment disease is seen in approximately 25% of knees with osteoarthritis, whereas isolated lateral compartment disease is only seen in 5% to 10%. 5 Historically, femoral and tibial osteotomies have been somewhat effective in treating unicompartmental disease that does not involve fullthickness cartilage lesions; however, they have not been effective in cases with full-thickness lesions.…”

“…In addition, UKA feels closer to a native knee and has a more normal gait pattern. 5 Data suggest that UKA is not always being performed when indicated. Medial UKA and lateral UKA constitutes only 11% (10% and 1%, respectively) of all knee arthroplasty procedures performed, whereas the combined rate of isolated medial and lateral disease is 30% to 40%.…”

“…Furthermore, the 10:1 ratio of medial to lateral UKA could also be attributed to a lack of familiarity with the procedure and the increased difficulty of lateral UKA because of the screwhome mechanism, which complicates the kinematic profile of the lateral compartment. 5 There are a limited number of studies investigating the survival of lateral UKA when compared with medial UKA, but the most recent data suggest that lateral UKA can be just as effective of a procedure as the medial UKA. 5 Outcomes hinge on proper patient and implant selection and surgical technique.…”

“…5 There are a limited number of studies investigating the survival of lateral UKA when compared with medial UKA, but the most recent data suggest that lateral UKA can be just as effective of a procedure as the medial UKA. 5 Outcomes hinge on proper patient and implant selection and surgical technique.…”