Cementless AGC revision of unicompartmental knee arthroplasty

Twenty-eight patients (29 knees) who had revision of a failed unicompartmental knee arthroplasty to total knee arthroplasty were evaluated. All revisions were made with cementless technique using the AGC prosthesis (Biomet, Warsaw, IN). Major osseous defects were found in 20 knees, and bone-grafting was used to fill the defects. Aseptic loosening and progression of osteoarthrosis were the main reasons for revision. The median follow-up period was 38 months. Twenty knees were excellent or good, four fair, and five poor. One tibial component had been revised because of loosening. Three knees with instability had been reoperated with a thicker polyethylene component, but one of these patients still suffered from instability, and revision with a constrained prosthesis was planned. One was revised after a deep infection. Two tibial components were suspected to be loose because radiographs exposed fluoroscopically revealed a complete radiolucent line under the component. The results with cementless revision and bone-grafting are comparable to the results achieved after cemented revision, and cementless revision is recommended in young patients and in patients with major bone loss.