Case Study: Simultaneous bilateral Unicondylar Knee replacement in 67 year old male

A 67 year old gentleman who presented to our clinic with a 2-year history of pain in both of his knees. He is a fit & healthy man who maintains an active lifestyle that includes golf, tennis and skiing.

He describes first noticing occasional pain in both of his knees that he did not feel the need to seek medical attention for, however this pain has worsened to the point of being quite bothersome and often preventing him from participating in the sporting activity he enjoys. Although there were occasions when one knee would hurt more than the other, these were temporary and overall he felt that each knee was as problematic as the other.

He had no pertinent medical history, drug allergies or smoking history.

His plain film radiographs revealed arthritic changes in both knees confined to his medial compartment. The extent of his arthritis was roughly equal in both knees and he had no major radiographic deformities.

His physical examination was largely unremarkable, save for some medial joint line tenderness on both sides. Specifically, he had no flexion contracture and his ACL was functionally intact. He had a small, fully correctable varus alignment to both knees.

We counselled the patient on his options, including non-surgical management. He specifically enquired about partial knee replacement surgery. We deemed him to be a candidate, and given that he was otherwise healthy with no major medical comorbidities and his arthritis was symptomatically and radiographically equal in both knees, we decided to plan for simultaneous bilateral Unicondylar Knee Arthroplasty.

We performed the surgery through a mid-vastus medial parapatellar approach in both knees. We replaced his medial compartment with appropriate components, and Mr. JY recovered well, being discharged from hospital the day after his surgery.

He recovered remarkably quickly, being approximately back to his baseline function within 6 weeks, and at 6 months post-surgery he was back playing golf, and slowly getting back to playing tennis again.

Pre-op

Simultaneous bilateral Unicondylar knee replacement in a 67-year-old male.

Post-op

Simultaneous bilateral Unicondylar knee replacement in a 67-year-old male.