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Knee

LATERAL PARTIAL KNEE ARTHROPLASTY VIA A LATERAL PARAPATELLAR SURGICAL APPROACH: SURGICAL TECHNIQUE AND EARLY CLINICAL OUTCOMES

The Knee Society (TKS) 2018 Members Meeting, Saint Louis, MO, USA, September 2018.



Abstract

Intro/Purpose

Lateral partial knee replacement is indicated as an alternative to total knee replacement for isolated end stage lateral compartment degenerative joint disease. The purpose of this study is to report the surgical technique and clinical results of a large series of lateral partial knee replacements from two institutions.

Methods

A retrospective review identified 205 lateral unicompartmental arthroplasty procedures performed in two practices over a six-year period (Aug 2011 – June 2017). Patients indicated for surgery met specific preoperative clinical and radiographic criteria confirming lateral compartment arthritic disease with a correctable deformity, intact full-thickness medial cartilage, competent anterior cruciate ligament, and minimal disease in the patellofemoral compartment. A single cemented fixed bearing tibial component design was used in all cases specifically designed for lateral compartment anatomy.

Results

The average age was 65 years old and 76% were female. Average follow-up in the lateral partials was 1.7 years (range 0.5 years to 6 years). Knee Society Scores improved from 45 (pre-op) to 88 points (post-op). Range of motion improved from 6–115o (pre-op) to 0–122 o (post-op). No knees were revised to a TKA. One knee had an additional medial partial knee placed at 1.1 years post lateral partial knee replacement for medial disease progression. Two knees required an irrigation and debridement for traumatic wound dehiscence.

Conclusion

This is the largest series of lateral partial knee replacements reported. Clinical improvements, range of motion, and survivorship were excellent at short-term follow-up. Long-term follow-up is needed for additional understanding of a novel implant designed specifically for the lateral compartment and the survivorship of the unreplaced compartments. We believe the lateral partial knee replacement to be a viable option for isolated lateral compartment disease in approximately 4% of patients.