Unicompartmental arthroplasty and high tibial osteotomy for osteoarthrosis of the knee. A comparative study with a 12- to 17-year follow-up period.
Comparable groups of patients with osteoarthritic knees who had either a St. Georg sledge unicompartmental arthroplasty or an upper tibial osteotomy were reviewed in 1985, five to ten years after operation. The results of unicompartmental arthroplasty were better, but it was uncertain whether the superior results would endure. The same groups have been reassessed after 12 to 17 years. Only 21 osteotomies and 15 unicompartmental arthroplasties remain. Good results were found in eight knees (42%) of the arthroplasty group and seven knees (21%) of the osteotomy group. Overall, five knees from the original cohort of 42 unicompartmental arthroplasties have required revision compared with 17 knees from the group of 49 osteotomies. This comparative analysis demonstrates that the superior early results from unicompartmental arthroplasty are maintained after a prolonged follow-up period. This prosthesis can be recommended with confidence to the elderly patient with unicompartmental osteoarthrosis.