96.
Hemicap- and Unicap – miniprosthesis and Hemicap patellofemoral
(
PF) - and PF-xl ( Wave ) – miniprosthesis.
Jens Ole Laursen
Orthopedic Sygehus Sønderjylland, Sønderborg
Background:
I introduced these implants in 2007 and 2009 respectively, and
have so far implanted 69 Hemicaps and 80 Unicaps.
Purpose / Aim of Study:
To present up to 5 years follow-up from a cohort of
149
ptts. operated with miniprosthesis.
Materials and Methods:
There was a protocol for the operations: all patients
had preoperative x-rays and MRI taken and all operations started with
arthroscopy to confirm if the cartilage damage was suitable for further CAP-
surgery and to deal with other damages to meniscus or cartilage.
Findings / Results:
Unicaps( fig.7): 35 ptt’s in 2009, 27 in 2010 and 18 in
2011 (
only on the femoral condyle). 9 ptt’s revised to TKA because of too
extensive osteoarthritis in more than one chamber! 2 ptt’s revised to TKA after
postop. infection ( second to re- arthroscopy ), and 5 ptt’s revised to TKA
because of aseptic loosening. 69 patients operated with the Hemicap(fig.5) and
4
revised, 3 due to more extencive lesions and arthrosis and one aseptic
loosening. Total caps: 149 in 5 years and 20 revised ( 13 % ), and cummulative
Survival rate(fig.6) at 93,5 % at 5 years for Hemicaps and 82% at 3,5 years for
Unicaps. PF- prosthesis:(fig.3) 2007: 1, 2008: 3, 2009: 3, 2010: 9, 2011: 9 = 25
TOTAL, 10 men and 15 women – mean age 49 years ( 31 – 84 ), BMI average
28, – 18
working and 7 at pension.
Conclusions:
So far I have found the HEMICAP promishing for restoration of
focal cartilage lesions in the knee in the “millennium patient” with isolated
cartilage lesions. The UNICAP addressing bigger cartilage lesions or minor
arthrosis is more problematic and indication must be quite narrow. Further
studies of both unicap and hemicap follow-ups are nessessary to confirm the
continuing use, and RCT – studies against Steadman’s micro-fracturing or
cartilage transplantation would be of great clinical interest.
