Objective: To explore the feasibility and short-term effectiveness of lateral unicompartmental knee arthroplasty (LUKA) through a lateral parapatellar approach for lateral compartmental osteoarthritis (LCOA).
Methods: Between November 2010 and August 2012, 15 consecutive patients (15 knees) with LCOA were treated with LUKA. There were 7 men and 8 women with a mean age of 67.3 years (range, 51-82 years). The mean duration of disease was 5.4 years (range, 3-15 years). The left knee was involved in 6 cases and the right knee in 9 cases. According to Ahlback rating, there were 2 cases (2 knees) of grade I, 8 cases (8 knees) of grade II, and 5 cases (5 knees) of grade III. Theincision length, operation time, blood loss, drainage, and complication were recorded. The pre- and post-operative knee function was evaluated by Hospital for Special Surgery (HSS) score system. The pre- and post-operative range of motion (ROM) and alignment of the lower limbs (hip-knee-ankle angle) were measured and compared.
Results: ACL rupture or medial compartmental osteoarthritis occurred in 2 patients (2 knees) who changed to total knee arthroplasty (TKA); 1 case (1 knee) failed to follow up. The other 12 cases (12 knees) were followed up 32.5 months on average (range, 26- 45 months). The mean length of incision was 6.9 cm (range, 6-8 cm); the mean operation time was 115.8 minutes (range, 90-155 minutes); the mean blood loss volume during operation was 152.2 mL (range, 105-250 mL); and mean drainage was 145.6 mL (range, 50-300 mL). At last follow-up, the average HSS score was significantly improved from 73.4 ± 4.6 preoperatively to 94.6 ± 2.1 postoperatively (t = 14.240, P = 0.000). The results were excellent in 9 cases, good in 2 cases, and fair in 1 case, with an excellent and good rate of 91.7%. The hip-knee-ankle angle was significantly decreased from valgus angle of (10.08 ± 1.38)° preoperatively to valgus angle of (5.17 ± 0.94)° postoperatively (t = 14.626, P = 0.000). Postoperative ROM was significantly improved to (123.75 ± 4.09)° from (108.67 ± 5.10)° preoperatively (t = 8.998, P = 0.000). Two patients developed superficial skin infection, which was managed with anti-inflammatory therapy and dressing. No patient had complication of deep vein thrombosis, prosthesis dislocation and loosing, or development of medial osteoarthritis.
Conclusion: LUKA through a lateral approach has the advantages of rapid recovery of joint function, less complication, and small trauma in the treatment of LCOA. Correct patient selection and further mid- and long-term studies, however, are essential.