The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis.

Abstract

We reviewed the results of sixty-one McKeever unicompartmental arthroplasties performed by the senior one of us (T. P.) for osteoarthritis of the knee. The average follow-up was five years (range, two to thirteen years). Forty-four (72 per cent) of the arthroplasties were rated as good to excellent. The average postoperative range of motion in these knees was 110 degrees. Six knees were rated as fair and eleven knees,

An investigation of the effect of conformity of knee hemiarthroplasty designs on contact stress, friction and degeneration of articular cartilage: A tribological study

“…The degradation of the opposing cartilage surface reported in the above studies (Emerson and Potter, 1985;Scott et al, 1985;Springer et al, 2006;Amstutz et al, 1994;D'Arcy and Devas, 1976;Hallock and Fell, 2003;Sisto and Mitchell, 2005;Bailie et al, 2008) suggests that the wear and degradation of the biomaterial-cartilage interface is of paramount importance in the development of hemiarthroplasties. Numerous studies have been carried out to investigate the wear of articular cartilage (AC) against itself and against different biomaterials using simple geometry pin-on-plate (POP) experiments (Freeman et al, 2000;, which give a good comparison of friction and wear using different materials.…”

“…There were some promising results in the 1980s with the McKeever metallic hemiarthroplasty which was roughly shaped like the tibial plateau (Emerson and Potter, 1985;Scott et al, 1985;Springer et al, 2006). However, in studies with this device, as well as clinical studies with the UniSpacer TM implant, degeneration of the opposing femoral cartilage and onset of osteoarthritis in other compartments were the most common causes of failure (Emerson and Potter, 1985;Scott et al, 1985;Springer et al, 2006;Amstutz et al, 1994;D'Arcy and Devas, 1976;Hallock and Fell, 2003;Sisto and Mitchell, 2005;Bailie et al, 2008).…”

“…However, in studies with this device, as well as clinical studies with the UniSpacer TM implant, degeneration of the opposing femoral cartilage and onset of osteoarthritis in other compartments were the most common causes of failure (Emerson and Potter, 1985;Scott et al, 1985;Springer et al, 2006;Amstutz et al, 1994;D'Arcy and Devas, 1976;Hallock and Fell, 2003;Sisto and Mitchell, 2005;Bailie et al, 2008). Some studies have reported very little success and do not recommend this device to patients (Sisto and Mitchell, 2005;Bailie et al, 2008).…”

“…In order to develop a hemiarthroplasty it is important to gain an in-depth understanding of how this implant would function tribologically in the natural knee joint. Questions which cannot be answered by simple POP experiments or computational studies include: how much degradation would a biomaterial implant impose on the opposing cartilage surface, a significant problem clinically (Emerson and Potter, 1985;Scott et al, 1985;Springer et al, 2006;Amstutz et al, 1994;D'Arcy and Devas, 1976); how will the implant perform under physiological loads and motions and how would using different implant geometries affect contact stress and wear? In healthy knee joints, the meniscus plays a very important role, adding conformity and reducing contact stress (Kettlekamp and Jacobs, 1972;Seedhom et al, 1974;Walker and Erkman, 1975;Krause et al, 1976).…”

Removal and successful re-implantation of a customized interpositional knee device following an early postoperative infection: A case report

“…It was introduced more than 50 years ago by MacIntosh [1] and a little later by McKeever and Elliott [2]. Clinical reports by Scott et al [3], Emerson et al [4] and Springer et al [5] showed good long-term results and easy revisions to unicompartmental (UKA) and total knee arthroplasty (TKA) with the McKeever device. These devices were partially fixed with a keel or rough underside and needed a wide exposure of the knee joint.…”