Case Report
Lateral Meniscal Injury After a Successful
Medial Unicompartmental Knee Arthroplasty
Marlon M. Mencia, FRCS (Tr & Orth), and Mark J. Ashworth, FRCS(Orth)
Abstract: A case of an active 52-year-old woman who, after a medial unicompartmental knee
arthroplasty, began complaining of lateral joint line pain and a persistent knee effusion. A lateral
meniscal tear was diagnosed clinically, and she underwent an arthroscopic partial meniscectomy that
resolved her problems. This case demonstrates the importance of considering a meniscal problem as
the cause of any unexplained joint line pain in the unoperated compartment after a successful
unicompartmental knee arthroplasty and not simply attributing it to progression of degenerative
change within the lateral compartment. Keywords: unicompartmental knee arthroplasty, meniscal
tear.
© 2010 Elsevier Inc. All rights reserved.
The Oxford unicompartmental knee arthroplasty (UKA)
has been shown in survival analysis studies to equal the
best results obtained with total knee arthroplasty [1,2].
Functionally, it performs more like a native knee joint,
and hence, it has been implanted in younger patients
with more active lifestyles than the traditional patient
undergoing total knee arthroplasty [3].
The case presented here demonstrates that quite like a
native knee, the uninvolved lateral compartment can
sustain meniscal injuries.
Case Report
A 52-year-old shopkeeper with significant anteromedial
osteoarthritis underwent a right UKA with the Oxford
prosthesis (Biomet Ltd, Bridgend, United Kingdom).
The Oxford phase III prosthesis was inserted using a
standard medial parapatellar approach. At surgery, there
were areas of exposed bone in the medial compartment,
the lateral compartment was not well visualized, and the
anterior cruciate ligament was functionally intact.
The recovery period was uneventful with the patient
being discharged home at 3 days.
At the 2-week clinic visit, the patient was noted to
walking comfortably and was pleased with the proce-
dure. However, at the 6-week review, a new problem
of lateral joint line tenderness was noted together with
an effusion and reduced range of movement. The
patient gave a history of a twisting injury to her right
knee while getting out of a car 1 week before her clinic
visit. There was no clinical evidence of infection, and
radiographs were satisfactory (Fig. 1). Based on the
clinical diagnosis of a lateral meniscal tear, day case
arthroscopy was performed 3 weeks later. A parrot beak
tear of the anterior horn of the lateral meniscus was
resected, and some minor fibrillation of the articular
cartilage was found (Fig. 2).
From the Torbay Hospital, Torquay, Devon, UK.
Submitted January 22, 2008; accepted November 26, 2008.
No benefits or funds were received in support of the study.
Reprint requests: Marlon M. Mencia, FRCS, The Fracture and
Orthopedic Clinic 29 a St Clair Ave, St Clair Trinidad , West Indies.
© 2010 Elsevier Inc. All rights reserved.
0883-5403/09/2502-0030$36.00/0
doi:10.1016/j.arth.2008.11.107
Fig. 1. Postoperative radiograph of Oxford unicompartmental
knee.
333.e7
The Journal of Arthroplasty Vol. 25 No. 2 2010