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The unicompartmental arthroplasty was originally performed for spontaneous osteonecrosis of the knee
7%
124/1698
An ACL reconstruction with bone-tendon-bone patellar tendon autograft was performed 30 years ago
16%
272/1698
Initial surgeon did not ask or identify signs of gout in the operative knee
27%
457/1698
Patient was >65years old at time of UKA
42%
712/1698
The patient had a medial meniscectomy 10 years prior to her unicompartmental arthroplasty
5%
93/1698
Select Answer to see Preferred Response
Because gouty arthritis affects the whole joint and not just one individual compartment, it is considered a contraindication to a partial knee replacement just as rheumatoid arthritis, psoriatic arthritis, or pseudogout. Unicompartmental arthroplasty is generally considered an excellent procedure provided that appropriate surgical indications are used for patient selection. Classic indications for unicompartmental arthroplasty include unicompartmental disease in patients older than 60 with relatively low activity demands. Additionally, the patients should weigh less than 82 kg, have minimal pain at rest, have motion >90 degress, and have minimal flexion and angular deformities. While most of these classic indications are still used today, recent studies are showing excellent results in younger, heavier, and more active patients. Heyse et al. retrospectively review the results of unicompartmental arthroplasty for spontaneous osteonecrosis of the knee (SONK). 75.7% of patients were "very satisfied" with the procedure and 21.6% were "satisfied." At 15 years, 90.6% of unicompartmental arthroplasties had not been revised. Overall, the authors feel it is an excellent procedure for SONK. Illustration A is a T2-weighted MRI demonstrating SONK. Incorrect Answers: Answer 1: Unicompartmental arthroplasties have shown excellent results for patients with SONK. Answer 2: A prior ACL reconstruction is not a contraindication to performing a unicompartmental arthroplasty. Answer 4: Older age is not a contraindication for a UKA and was classically reserved for older individuals. Answer 5: A prior medial meniscectomy is not a contraindication for a unicompartmental arthroplasty.
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