A Mid-term Follow-up Study Of Unicompartmental Arthroplasty In The Group Of Young

Objective: Unicondylar knee arthroplasty（UKA） is a treatment forunilateral tibiofemoral joint between the surgical room lesions, the surgeryonly change the destructive side of knee joint which is resurfacing, thesurgery has retained cruciate ligament,less surgical trauma, less bleeding,faster recovery, more easily renovated to retain bone mass, fewercomplications and low cost. UKA surgery with the optimized design ofsophisticated surgical techniques, patients significantly improved long-termsurvivals. Clinical efficacy which most patients reported was60years old,60years old patient reported less. This paper evaluated patients under the age of60with UKA after an average follow-up (5.2±0.8) years. UKA reportedmostly in patients aged60years or more and exercise less. Most of theprevious literature reports that unicompartmental knee arthroplasty withdesign immature, prone to complications such as polyethylene wear anddislocation, so that the prosthesis is only applicable to the lower activityintensity elderly. At present, many foreign authors believe that young peoplewith extremity muscle strength strong, joint general function better, whichhelp restore knee function, such as postoperative rehabilitation exercisesproperly, equally satisfactory postoperative results. But the effect in the groupof intensity activity of young people under the age of60with surgery ofunicompartmental knee arthroplasty is unreported in the country. This paperevaluate the mid-term clinical outcome of UKA in the group of young.Methods: The follow-up from April2007to January2010.19cases(21knees) of under60years following unicompartmental knee arthroplastypatients. All patients completed the operation by the same physician, after thefirst day we postulate the patients to autonomous straight leg raisingexercises and joint flexion and extension exercises, the first two days can walk from the bed and began to encourage patients to knee fully extended (patientself-stretching and extensor force, nursing staff assisted stretching to the backof the knee with the bed surface without gaps); flexion function and flexibilityexercises (hold knee genuflex on bed, bedside row leg "kick" action); exercisenormal gait (walking with not shake the shoulder, do not shake the waist in themirror practicing). We evaluate the effect of the surgery by using Hospital forspecial surgery knee score, HSS score, The western Ontario and McMasteruniversities osteoarthritis index, WOMAC score, Visual Analogue Scale/Score, VAS score, maximum range of motion, Feller patellar score record.Before and after surgery and the last follow-up knee lateral X-ray, femoraltibiofemoral angle (FTA) and lateral tibiofemoral joint space width and wetook the revision rate as a final assessment of the standard prosthesis survival.Results: All patients were followed up for4to6.5years (mean,5.2years), the survivalship was95.2%; one revision was performed due topolyethylene spacer frayed and prosthesis aseptic loosening. One case showedpolyethylene spacer were frayed but no clinical symptom. The postoperativeHSS was (88.1±6.8), which was (60.4±5.2) preoperatively. The postoperativeWOMAC was (11.5±6.5), which was (42.9±5.9) preoperatively. Thepostoperative VAS was (1.1±1.8), which was (6.6±0.7) preoperatively.Thepostoperative ROM was (121.2°±11.1°), which was (113.8°±11.5°)preoperatively. The postoperative Feller score was (25.2±6.6), which was(19.3±7.0) preoperatively. The postoperative FTA was(175.3°±2.4°), whichwas (179.5°±3.8°)preoperatively. The postoperative width of lateraltibiofemoral joint space was (6.7mm±0.6mm), which was (6.8mm±0.6mm)preoperatively. No deterioration of the laterally compartment andpatellofemoral joint cartilage destruction happened.Conclusion: The outcome of UKA in patients under the age of sixty wassatisfied and the survivalship of the implant was good.