학술논문
Unicompartmental knee arthroplasty for younger patients: an alternative view.
Document Type
Academic Journal
Author
Deshmukh RV; Harvard Combined Orthpaedic Surgery, Boston, MA, USA.; Scott RD
Source
Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0075674 Publication Model: Print Cited Medium: Print ISSN: 0009-921X (Print) Linking ISSN: 0009921X NLM ISO Abbreviation: Clin Orthop Relat Res Subsets: MEDLINE
Subject
Language
English
ISSN
0009-921X
Abstract
Unicompartmental knee arthroplasty has been a controversial operation for the past 3 decades. Many surgeons in the 1980s and 1990s found little or no indication for the procedure. Others were enthusiastic for its use in selected patients with osteoarthritis who had unicompartmental disease. Initially, unicompartmental knee arthroplasty was thought to be appropriate for the elderly patient who was sedentary. With the advent of minimally invasive techniques, indications have expanded to include its use in younger patients (especially females) as an alternative to osteotomy or tricompartmental knee arthroplasty. Advantages over osteotomy include higher initial success, greater longevity, and fewer early complications. If done conservatively, salvage is not difficult. The extent of safe postoperative activity levels has yet to be established. Failure rates seem to be higher in heavy active males. A metallic interposition hemiarthroplasty in the form of a McKeever or Macintosh prosthesis has been available for 50 years as a unicompartmental arthroplasty, but with limited use. It still may have a role in selected patients as a conservative temporizing procedure.