Background: Knee arthritis in the young patient is a challenging
problem that may necessitate surgical treatment. We continue to perform
hemiarthroplasty with a metallic tibial implant in selected young patients
who, for various reasons, are not candidates for osteotomy, unicompartmental
arthroplasty, or total knee arthroplasty. The purpose of the present study was
to determine the minimum twelve-year results of this procedure in young
Methods: The original study group consisted of a consecutive series
of twenty-four patients (twenty-six knees) who were managed with McKeever
tibial hemiarthroplasty for the treatment of unicompartmental osteoarthritis
of the knee. All patients were younger than sixty years of age at the time of
the index procedure (average age, 44.6 years). During the study period, two
patients died and one was lost to follow-up, leaving twenty-one patients
(twenty-three knees) available for review. All patients were followed
clinically for a minimum of twelve years or until revision. Knee Society knee
and functional scores and Tegner scores were determined, and seven of the ten
implants were evaluated radiographically.
Results: Thirteen knees were revised at an average of eight years
after the index procedures. All thirteen knees had an uncomplicated revision
to either a unicompartmental arthroplasty or total knee arthroplasty. Ten
retained implants were available for clinical review after an average duration
of follow-up of 16.8 years. The mean Knee Society knee scores, functional
scores, and Tegner scores, available for nine of these ten knees, were 80, 97,
and 4.2, respectively.
Conclusions: We believe that the McKeever tibial hemiarthroplasty
continues to be a reasonable surgical option for patients who are not
candidates for osteotomy and are too young or too active for a
unicompartmental or total knee arthroplasty.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.