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McKeever hemiarthroplasty of the knee in patients less than sixty years old
Bryan D Springer1, Richard D Scott, Alexander P Sah
1Department of Orthopaedic Surgery, New England Baptist Hospital, 75 Francis Street, Boston, MA 02115, USA. bryan.springer@orthocarolina.com
Insights
McKeever tibial hemiarthroplasty offers a viable surgical option for young patients with knee arthritis unsuitable for other procedures. Long-term follow-up shows reasonable outcomes, though some cases require revision.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Knee arthritis in young patients presents complex treatment challenges.
- McKeever tibial hemiarthroplasty is used for select young patients ineligible for osteotomy, unicompartmental arthroplasty, or total knee arthroplasty.
- This study evaluates the minimum 12-year outcomes of this procedure in a young patient cohort.
Purpose of the Study:
- To determine the minimum 12-year results of McKeever tibial hemiarthroplasty in young patients with unicompartmental knee osteoarthritis.
- To assess the long-term efficacy and potential need for revision of this surgical technique.
Main Methods:
- A consecutive series of 24 patients (26 knees) younger than 60 years underwent McKeever tibial hemiarthroplasty.
- Follow-up included clinical assessment (minimum 12 years or until revision), Knee Society scores, and Tegner scores.
- Radiographic evaluation was performed on available implants.
Main Results:
- Thirteen knees (50%) required revision surgery at an average of 8 years post-procedure.
- Ten implants were retained at an average follow-up of 16.8 years.
- Mean Knee Society knee and functional scores for retained implants were 80 and 97, respectively, with a mean Tegner score of 4.2.
Conclusions:
- McKeever tibial hemiarthroplasty remains a reasonable surgical choice for young, active patients with knee osteoarthritis who are not candidates for other joint procedures.
- The procedure provides a viable option when osteotomy or other arthroplasty types are not suitable.
- While revision is sometimes necessary, the retained implants show satisfactory functional outcomes in the long term.
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 patients.
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.
