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CASE 4
GRADE III LATERAL OA IN ACTIVE 60 YRS OLD WOMAN
UKA
Carsten Oliver Tibesku
Straubing, Germany
1. Invasiveness
UKA provide a less invasive approach than TKA, including less blood loss, less infections, a shorter
hospital stay, and a faster recovery. UKA is less expensive than TKA [1].
2. Patient satisfaction
The perceived patient satisfaction is higher in UKA than TKA [2, 3].
3. Function
Although deep flexion can also be achieved with modern TKA, the following parameters are more normal
and closer to the healthy knee in UKA than TKA: kinematics of the knee [4], ap- and ml-stability [5],
restoration of joint line, muscle activity (EMG) [6-8], muscle strength [6], proprioception [6-8], and gait [6-
8].
4. Longevity
Long-term survival of lateral UKA and TKA are comparable, with newer lateral UKA implants achieving a
10-year-survival of 92% and 16-year-survival of 84% [1, 9].
5. Ease of revision
Lateral UKA can easily be revised to primary total knee replacements. Revision of UKA is cheaper than of
TKA. The results of revision TKA after UKA appear to be better than after HTO or TKA [1, 10].
References
1. Heyse TJ, Tibesku CO. Lateral unicompartmental knee arthroplasty: a review. Arch Orthop Trauma Surg. 2010;130(12):1539-
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2. Laurencin CT, Zelicof SB, Scott RD, Ewald FC. Unicompartmental versus total knee arthroplasty in the same patient. A
comparative study. Clin Orthop Relat Res. 1991 (273): 151-6
3. Rougraff BT, Heck DA, Gibson AE. A comparison of tricompartmental and unicompartmental arthroplasty for the treatment
of gonarthrosis. Clin Orthop Relat Res. 1991 (273): 157-64
4. Argenson JN, Komistek RD, Aubaniac JM, Dennis DA, Northcut EJ, Anderson DT, et al. In vivo determination of knee
kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty. 2002; 17(8): 1049-54
5. Becker R, Mauer C, Starke C, Brosz M, Zantop T, Lohmann CH, et al. Anteroposterior and rotational stability in fixed and
mobile bearing unicondylar knee arthroplasty: a cadaveric study using the robotic force sensor system. Knee Surg Sports
Traumatol Arthrosc. 2012
6. Fuchs S, Frisse D, Laass H, Thorwesten L, Tibesku CO. Muscle strength in patients with unicompartmental arthroplasty. Am
J Phys Med Rehabil. 2004; 83(8): 650-4; quiz 5-7, 62
7. Fuchs S, Frisse D, Tibesku CO, Laass H, Rosenbaum D. Proprioceptive function, clinical results, and quality of life after
unicondylar sledge prostheses. Am J Phys Med Rehabil. 2002; 81(7): 478-82
8. Fuchs S, Rolauffs B, Plaumann T, Tibesku CO, Rosenbaum D. Clinical and functional results after the rehabilitation period in
minimally-invasive unicondylar knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc. 2005; 13(3): 179-86
9. Argenson JN, Parratte S, Bertani A, Flecher X, Aubaniac JM. Long-term results with a lateral unicondylar replacement. Clin
Orthop Relat Res. 2008; 466(11): 2686-93
10. Chatain F, Richard A, Deschamps G, Chambat P, Neyret P. [Revision total knee arthroplasty after unicompartmental
femorotibial prosthesis: 54 cases]. Rev Chir Orthop Reparatrice Appar Mot. 2004;90 (1): 49-57
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