A novel preoperative scoring system for the indication of unicompartmental knee arthroplasty, as predictor of clinical outcome and satisfaction.

Abstract

Proper patient selection is a crucial factor for the outcome of the unicompartmental knee arthroplasty (UKA). However, there is still not a clear consensus on which patients could benefit the utmost from a UKA. The purpose of this prospective study was to introduce a novel, preoperative, predictive score (Unicompartmental Indication Score, UIS) to aid proper patient selection in UKA. A total of 152 patients with an average age of 68years and a mean follow-up of 27months were evaluated preoperatively with the UIS and postoperative at every follow-up. Correlation analysis was applied to identify potential relationships between the UIS, functional outcomes, pain relief, patient satisfaction, and range of motion. The ROC analysis was used to identify the best cutoff value of the UIS, which would have predicted an optimal outcome following UKA. The majority of the patients (91%) were satisfied with the operation, with 61% reporting excellent and 30% good satisfaction. The UIS was positively correlated to the postoperative Knee Society Score (KSS) for both pain (r = 0.26, p < 0.001) and function (r = 0.31, p < 0.001). The UIS was also positively correlated to the patient satisfaction (p = 0.46, p < 0.001) and maximum postoperative flexion (r = 0.25, p < 0.001). The ROC analysis provided an ideal cutoff for UIS at 25 points (sensitivity: 75%, sensibility: 93%, area under the curve: 86%). At a mean follow-up of 27months (range 24-37), we observed three revisions in 152 consecutive UKA with a mean UIS of 27 points (range 20-30). The newly introduced UIS score might be a reliable preoperative scoring system to predict patients with excellent satisfaction, functional outcome, pain relief and possibly implant survivorship following UKA, and therefore, could help the proper patient selection and decision-making in UKA. Prospective study, II.