RÉSULTATS À MOYEN TERME DES PROTHÈSES UNICOMPARTIMENTALES DU GENOU À MADAGASCAR MEDIUM-TERM RESULTS OF UNICOMPARTMENTAL KNEE ARTHROPLASTY IN MADAGASCAR

Abstract

Introduction: the unicompartmental knee arthroplasty (UKA) is a globally recognized procedure for the treatment of osteoarthritis of a tibiofemoral compartment. It was carried out in Madagascar since 2012 at the Joseph Ravoahangy Andrianavalona University Hospital Center (CHU-JRA) and this study is the first study concerning the UKA carried out in the country. The objective of this study is to assess the medium-term results of PUCs in Madagascar.

Methods: this was a six-year prospective study from 2012 to 2017 carried out in the Department of Orthopedic Surgery and Traumatology of the CHU-JRA Antananarivo including all patients who received a UKA.

Results: twelve UKA were placed in eight patients. The mean age of the patients was 73.5 years. Mechanical pain in the internal compartment of the knee was the complaint of all patients, and the diagnosis of internal tibial osteoarthritis was confirmed after the x-ray. An improvement in the IKS (International Knee Society) score was found, with the average overall score which had gone from 132.5 preoperatively to 190 at the last follow-up, an IKS knee average score increased from 65 to 95 and an IKS score function increased from 67.5 to 95. After a mean follow-up of four years, the quality of life of the patients was excellent with the KOOS (Knee Injury and Osteoarthritis Outcome Score) which went from 26/100 before the operation to 98/100. Apart from a loosened prosthesis no other complication were found.

Conclusion: UKA is an ideal treatment for isolated osteoarthritis of a tibiofemoral compartment. It offers better physiological function, a less invasive surgical approach, a faster recovery time. This first study in Madagascar concerning the PUC found excellent mediumterm results but long-term patient follow-up will be necessary.