Medial unicompartmental knee arthroplasty with the Miller-Galante prosthesis

Background: Unicompartmental knee arthroplasty has become a popular treatment alternative for osteoarthritis that is confined to the medial part of the knee. Excellent intermediate-term results recently have been reported in association with the Miller-Galante unicompartmental implant. The purpose of the present study was to report on our longer-term experience with the Miller-Galante medial unicompartmental knee implant. Methods: We evaluated the results of 113 medial unicompartmental knee arthroplasties that had been performed with use of the Miller-Galante implant in eighty-four patients between 1989 and 2000. The mean age of the patients at the time of surgery was sixty-eight years. Forty-five patients were men, and thirty-nine were women. Thirteen patients (sixteen knees) died at a mean of seven years after the index arthroplasty. No patient was lost to follow-up. The remaining seventy-one patients (ninety-seven knees) were followed for a mean of ten years and were evaluated with use of the Knee Society clinical and radiographic rating system. Results: Eleven knees were revised at a mean of four years after the index procedure. The mean Knee Society knee and function scores for the sixty-one patients (eighty-six knees) who were living and who had not had a revision improved from 48 and 53 points preoperatively to 93 and 80 points at the time of the most recent evaluation. The five and ten-year rates of survival were 94% and 90%, respectively, with revision to tricompartmental knee arthroplasty as the end point and 93% and 86%, respectively, with revision or radiographic loosening as the end point. Conclusions: The Miller-Galante medial unicompartmental knee arthroplasty provided excellent pain relief and restoration of function in carefully selected patients and demonstrated durable implant survival at ten years. Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.