Clinical outcomes of unicompartmental knee arthroplasty in early osteoarthritis without bone-on-bone contact.

Background and purpose There is disagreement in the literature about the importance of patellofemoral joint degeneration and knee pain for the outcome of unicompartmental knee arthroplasty (UKA). We therefore investigated the importance of selected predictors including patellofemoral joint degeneration and the location of preoperative knee pain for the early outcome of UKA.Patients and methods The study group comprised 260 consecutive patients from 5 hospitals who underwent Oxford UKA for anteromedial osteoarthritis. Data were collected at baseline and included pain location, radiologically observed degeneration of the patellofemoral joint including subluxation of the patella, intraoperative cartilage status of the patellofemoral joint, disease-specific knee status, and Oxford knee score (OKS). Outcomes were evaluated after 1 year using the OKS, global patient satisfaction, and global patient result.Results The average OKS score at baseline was 24 (SD 7), and it was 40 (SD 8) at the 1-year follow-up. 94% of the patients claimed improvement after the operation and 90% were satisfied with the UKA. Lateral subluxation of the patella was a predictor of poor outcome, and the preoperative OKS score was also a predictor of outcome. Full-thickness cartilage loss at any location gave a similar outcome to that with a normal or near-normal joint surface, and likewise, preoperative anterior knee pain was not a predictor of outcome.Interpretation We conclude that the good early outcome after UKA in this study is in line with the best reported results. Patellofemoral degeneration should not be considered a contraindication to Oxford UKA. Patients with lateral subluxation of the patella have an increased risk of a poor result after UKA and should preferably be offered a total knee replacement.

Prior Anterior Cruciate Ligament Reconstruction Does Not Compromise the Functional Outcomes of Medial Unicompartmental Knee Arthroplasty Although Revision for Progressive Arthritis May Occur Earlier.

Unicompartmental knee arthroplasty (UKA) has gained significant attention in recent years as an important treatment option for isolated compartmental osteoarthritis of the knee, offering distinct advantages over Total Knee Arthroplasty (TKA). This review article aims to comprehensively analyze the clinical outcomes of UKA, focusing on surgical techniques, patient satisfaction, functional improvement, implant survivorship, complications and future directions. Through an examination of current literature and clinical studies, this review provides valuable insights into the efficiency and limitations of unicompartmental knee arthroplasty as a surgical intervention for managing unicompartmental knee pathology, with an emphasis on its growing role in modern orthopedic practice. AIM OF THE STUDY: The aim of the study is to evaluate the available knowledge about surgical techniques and clinical outcomes of Unicompartmental Knee Arthroplasty, highlight its strengths and weaknesses and benefits compared to Total Knee Arthroplasty. MATERIALS AND METHODS: The literature available in PubMed, Google Scholar, BMJ, JBJS, JOSR, database was reviewed using the following keywords: “UKA”, “Knee”, “Arthroplasty”, “TKA”, “Recovery” , “Clinical Outcomes”. RESULTS: A review of the literature underscore the importance of tailored treatment decisions, emphasizing that UKA is best suited for patients with unicompartmental osteoarthritis who meet strict selection criteria. Its benefits make it a strong choice in such cases, but careful consideration is needed for long-term success.

Unicompartmental knee arthroplasty (UKA) provides significant benefits to patients with anteromedial osteoarthritis, with good long-term results. Morbidity and mortality rates are lower, and recovery is quicker. These benefits would be advantageous to the octogenarian population whom carry significant comorbidities. The primary aim was to compare the short-term functional outcome at 2years of UKA in the octogenarian population against a stratified younger cohort of patients. We hypothesised that the octogenarian population would have equally significant improved patient-reported outcome measures. Prospective patient-reported outcome measures, including Oxford Knee Score (OKS), satisfaction rates and Euro-Quol (EQ-5D) scores at 1-year and 2-year post-operative data, were collected and analysed. Three hundred and ninety-five medial Oxford Phase 3 UKA implants were evaluated. Mean follow-up was 4.7years (range 2.1-7.7). Secondary outcomes including revision rates, length of stay, complications and mortality were recorded. Our patient population was stratified into three cohort groups based on age: 60-69, 70-79 and 80-89years. The OKS and EQ-5D score improved significantly in all three groups at all post-operative time periods and maintained at 2years. The OKS at 2years post-operatively by age was 39.5 (SD 18.6), 39.2 (SD 17.7) and 39.3 (SD 15.9), respectively. No significant difference of implant survival was found between the groups. The overall revision rate was 28/395 (7%). The 90-day mortality in the present series was one patient. The 2-year short-term functional outcome, revision rates and satisfaction of UKA in the octogenarian population did not differ statistically from other age groups. III.

Early Outcomes of Unicompartmental Knee Arthroplasty in Patients With Preoperative Genu Recurvatum of Non-neurological Origin

The general recommendation for a failed primary unicompartmental knee arthroplasty (UKA) is revision to a total knee arthroplasty (TKA). The purpose of the present study was to compare the outcomes, intraoperative data, and mode of failure of primary UKAs and primary TKAs revised to TKAs. The study was based on 768 failed primary TKAs revised to TKAs (TKA→TKA) and 578 failed primary UKAs revised to TKAs (UKA→TKA) reported to the Norwegian Arthroplasty Register between 1994 and 2011. Patient-reported outcome measures (PROMs) including the EuroQol EQ-5D, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and visual analog scales assessing satisfaction and pain were used. We performed Kaplan-Meier and Cox regression analyses adjusting for propensity score to assess the survival rate and the risk of re-revision and multiple linear regression analyses to estimate the differences between the two groups in mean PROM scores. Overall, 12% in the UKA→TKA group and 13% in the TKA→TKA group underwent re-revision between 1994 and 2011. The ten-year survival percentage of UKA→TKA versus TKA→TKA was 82% versus 81%, respectively (p = 0.63). There was no difference in the overall risk of re-revision for UKA→TKA versus TKA→TKA (relative risk [RR] = 1.2; p = 0.19), or in the PROM scores. However, the risk of re-revision was two times higher for TKA→TKA patients who were greater than seventy years of age at the time of revision (RR = 2.1; p = 0.05). A loose tibial component (28% versus 17%), pain alone (22% versus 12%), instability (19% versus 19%), and deep infection (16% versus 31%) were major causes of re-revision for UKA→TKA versus TKA→TKA, respectively, but the observed differences were not significant, with the exception of deep infection, which was significantly greater in the TKA→TKA group (RR = 2.2; p = 0.03). The surgical procedure of TKA→TKA took a longer time (mean of 150 versus 114 minutes) and more of the procedures required stems (58% versus 19%) and stabilization (27% versus 9%) compared with UKA→TKA. Despite TKA→TKA seeming to be a technically more difficult surgical procedure, with a higher percentage of re-revisions due to deep infection compared with UKA→TKA, the overall outcomes of UKA→TKA and TKA→TKA were similar.

Effect of tibial component position on short-term clinical outcome in Oxford mobile bearing unicompartmental knee arthroplasty

BackgroundThis study compared early clinical outcomes of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in patients with anteromedial osteoarthritis (AMOA) and class II obesity during postoperative hospitalization and at 1, 6, and 8 months postoperatively.MethodsA retrospective analysis was conducted on 85 patients with class II obesity who underwent UKA (n = 45) or TKA (n = 40) between January 2022 and January 2024. Perioperative parameters, including operative time, incision length, hemoglobin and albumin levels on postoperative day 2, and hospital stay, were compared. Functional outcomes were assessed using the visual analog scale (VAS), Hospital for Special Surgery (HSS) knee score, and range of motion (ROM) before surgery and at 1, 6, and 8 months postoperatively. Complication rates were also recorded.ResultsAll patients completed surgery successfully. The UKA group had significantly shorter operative times, smaller incisions, higher postoperative hemoglobin and albumin levels, and shorter hospital stays (P < 0.01). At 1 and 6 months, UKA patients showed better VAS, HSS scores, and ROM (P < 0.05). By 8 months, no significant differences remained. Complication rates were lower in the UKA group (2.22%) than in the TKA group (17.5%) (P < 0.05).ConclusionBoth UKA and TKA improve pain and function in AMOA patients with class II obesity. However, UKA offers advantages in perioperative recovery, early functional outcomes, and complication rates, supporting its use in appropriately selected patients.

This prospective randomized study compared the clinical and radiographic outcomes of unicompartmental knee arthroplasty versus total knee arthroplasty. The group consisted of 34 patients (19 males and 15 females), who had a mean age of 73 years (range, 49 to 86 years), and who fit the criteria for bilateral unicompartmental knee arthroplasty. Each patient received a unicompartmental prosthesis in one knee and a total knee arthroplasty in the other during a single anesthetic session. At a mean follow-up of 5 years (range, 24 to 89 months), the Knee Society pain and function scores were similar for both groups. There were no radiographic failures. Survivorship of the unicompartmental group was 85% compared with 100% in the total knee group (p = 0.05). All of the prostheses that failed had an all-polyethylene tibial component. These results suggest that unicompartmental knee arthroplasty may not offer similar survivorship when compared with total knee arthroplasty.

To compare the mid-term outcomes of unicompartmental knee arthroplasty (UKA) that was performed in one knee and total knee arthroplasty (TKA) performed in the other knee in the same stage. This is a retrospective study. A total of 63 patients (126 knees) scheduled for one-stage knee surgery due to osteoarthritis of both knees were selected, and all patients underwent one-stage mobile platform UKA and TKA of the other knee. Differences in general clinical data, functional recovery, complications, and prosthesis revision rates were assessed after UKA and TKA, respectively. The evaluation indicators for knee joint function recovery included the hospital for special surgery knee score (HSS), Joint Forgotten Score (JFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Visual analog scale (VAS). Patient preference between UKA and TKA was also recorded. During a mean follow-up of 76.95 months (range, 65.00 to 87.00 months), there were no significant differences in postoperative complications between the two groups (P = 0.299); however, the prosthesis revision rate was higher in the UKA group than in the TKA group (P = 0.023). The incision length, operation time, blood loss, and postoperative drainage volume in the UKA group were significantly (P < 0.001) lower than those in the TKA group: JFS, ROM, and VAS in the UKA group were higher than those in the TKA group (P < 0.001, P = 0.023, P = 0.032), HSS and KOOS in TKA group were significantly (P < 0.001) higher than those in UKA group. At the last follow-up, 40% and 24% of patients preferred TKA and UKA, respectively. TKA was found to be superior to UKA in terms of HSS, KOOS, and VAS, while UKA had more significant advantages in terms of less surgical trauma, better ROM, and higher JFS. Complications were not different between groups, but UKA had a higher rate of prosthesis revision. After a follow-up of at least 5 years, more patients preferred TKA.

Osteoarthritis has become the predominant manifestation of arthritic conditions on a worldwide scale and serves as a significant instigator of pain, impairment, and increasing socio-economic strain on a global level. The ongoing discourse on the choice between total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) for patients suffering from anterior medial osteoarthritis continues to ignite scholarly controversy. Our objective was to assess and compare the clinical outcomes of UKA and TKA within the same patient, hereby offering a novel perspective on this topic. Fifty-seven individuals who underwent TKA on one knee and UKA on the other knee at the Department of Orthopaedics, First Hospital of Hebei Medical University between March 2019 and March 2024 were analysed for this retrospective study. We conducted a comprehensive examination and evaluation of perioperative laboratory assessments, radiological examinations, knee functionality, contentment levels, and postoperative complications within the two groups. Following surgical procedures, levels of hemoglobin, red blood cells, and albumin were found to be elevated in the UKA group when compared to the TKA group (hemoglobin: 121.2 ± 12.54 vs. 110.1 ± 13.21g/L; red blood cells: 4.0 ± 0.47 vs. 3.6 ± 0.42 *1012/L; albumin: 37.7 ± 5.66 vs. 35.3 ± 5.23g/L). There is a significant difference in the hip-knee-ankle angles between the postoperative UKA group and the TKA group (5.3 ± 3.46° vs. 4.1 ± 2.86°, p < 0.05). There existed no notable disparity in postoperative visual analog scale, knee society score, and forgotten joint score between the two groups. However, a remarkable variance was observed in postoperative range of motion between the two groups (116.4 ± 5.96° vs. 108.4 ± 5.32°). We found that UKA resulted in less physical strain, less postoperative inflammatory response, improved joint mobility, although with less effective lower limb force line correction compared to TKA. Many patients have shown a preference for UKA and express higher levels of satisfaction with the procedure.

BackgroundThis study was performed to compare the clinical outcomes of unicompartmental knee arthroplasty (UKA) revised to total knee arthroplasty (TKA) versus primary TKA.MethodsRelevant trials were identified via a search of the Cochrane Central Register of Controlled Trials and PubMed from inception to 17 June 2017. A meta-analysis was performed to compare postoperative outcomes between revised UKA and primary TKA with respect to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS), mean polyethylene thickness, hospital stay, revision rate, range of motion (ROM), and complications.ResultsFive of 233 studies involving 536 adult patients (revised UKA group, n = 209; primary TKA group, n = 327) were eligible for inclusion in the meta-analysis. The primary TKA group had better WOMAC scores, KSS, and ROM than the revised UKA group (P < 0.05). Compared with primary TKA, revision of UKA to TKA required more augments, stems, and bone grafts and a thicker polyethylene component (P < 0.05). There were no significant differences between the two groups in the revision rate, hospital stay, or complications (P > 0.05).ConclusionConversion of UKA to TKA is associated with poorer clinical outcomes than primary TKA. Furthermore, we believe that conversion of UKA to TKA is more complicated than performing primary TKA. Revision UKA often requires more augments, stems, and bone grafts and thicker polyethylene components than primary TKA. However, patients who undergo conversion of UKA to TKA have similar hospital stay, complications, and revision rate as patients who undergo primary TKA.

Objective To study the shortterm clinical outcomes of unicompartmental knee arthroplasty for medial compartmental knee osteoarthritis, and to compare 2 kinds of unicompartmental prosthesis. Methods From March 2010 to June 2013, data of 43 patients underwent unicompartmental knee arthroplasty (UKA) were retrospectively analyzed. 17 patients (17 knees) used rotating platform prosthesis, and 26 patients (28 knees) used fixed bearing prosthesis. There were 7 males (7 knees) and 9 females (10 knees) in rotating platform group, with an average age of 64.1 years (range, 54-82 years); while 10 males (10 knees) and 17 females (18 knees) in fixed bearing group, with an average age of 62.2 years (range, 43-79 years). All patients presented signs of narrowed medial joint space, medial tenderness and pain on weight-bearing. X-ray and MRI were used for documenting joint narrowing and cartilage defect. The pain and the knee functions were recorded both pre and post-operatively with knee society score (KSS), 2 cases of simultaneous anterior cruciate ligament (ACL) reconstruction were assessed with Tegner-Lysholm knee scoring scale as well. Results All 43 patients were followed up for 6 month to 37 months, and the average duration was 21.1 months. There were no dislocations, joint infection, deep venous thrombosis, prosthetic loosening, etc. The KSS in rotating platform group was 56.11±9.51 preoperatively, and 92.23±5.46 postoperatively. While the KSS in fixed bearing group was 57.11±9.56, and 93.69±6.37, respectively. There were statistical differences comparing between preoperative and postoperative KSS knee scores.There was no significant difference in KSS scores between rotating platform group and fixed bearing group. Conclusion Unicompartmental knee arthroplasty is a less invasive and effective method for knee osteoarthritis in medial compartment with less complications. There was no significant difference in clinical outcomes between rotating platform and fixed bearing design in terms of patients' satisfactory rate, clinical and functional outcomes in this shortterm followup study. Key words: Knee joint; Osteoarthritis; Arthroplasty, replacement, knee

To compare clinical outcomes of unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA). A systematic review and meta-regression to compare postoperative outcomes of pain VAS, knee function score, range of motion, complications and revision surgery rates between UKA and TKA were conducted. Relevant randomized controlled trials were identified from MEDLINE and Scopus from inception to August 29, 2014. Three of 1056 studies were eligible; two, three, two, three and three studies were included in pooling of pain visual analog score (VAS), Knee Society Score (KSS) and Bristol Knee Score (BKS), maximum knee flexion, postoperative complications (aseptic loosening, progressive degenerative joint disease of lateral compartment, bearing dislocation, DVT, fractures and infection) and revision rates, respectively. The unstandardized mean difference (UMD) of the function scores (KSS, BS) for UKA was 1.62 (95 % CI -1.17, 4.42) better than TKA and for pain score was 0.1 (95 % CI -3.54, 3.73) higher than TKA, but both without statistical significance. UKA was more likely to show higher mean maximum knee flexion with a UMD of 1.88 (95 % CI -0.54, 4.30) when compared to TKA, but was also not statistically significant. UKA had a statistically significant lower chance of postoperative complications by 0.35 U (95 % CI 0.12, 0.98) when compared to TKA, but had higher revision rates than TKA with a value of 5.36 (95 % CI 1.06, 27.08). In short-term outcomes (5 years or less, with follow-up of 0-5 years), TKA had higher postoperative complications than UKA, but had lower revision rates. There was only one study that reported long-term survivorship (more than 5 years, with follow-up of 5-15 years). Further research that assesses long-term survivorship is necessary to better evaluate UKA and TKA in the treatment of unicompartmental knee osteoarthritis.

This study aims to compare clinical outcomes in unicompartmental knee arthroplasty (UKA) patients with or without magnetic resonance imaging (MRI) evidence of bone marrow edema (BME) in the patella and to evaluate the effect of functional outcomes after UKA in patients with patellofemoral osteoarthritis (PF OA). Outcomes of 146 knees in 141 patients who underwent medial UKA were included. According to their preoperative condition of patellofemoral joints, patients were divided into three groups: Group A, non-PF OA (Kellgren–Lawrence [K–L] scale = 0); group B, PF OA without BME (K–L ≥ 1, bone marrow edema pattern [BMEP] = 0); group C, PF OA with BME (K–L ≥ 1, BMEP ≥ 1). Clinical outcomes including visual analog scale (VAS) scores of knee pain, Hospital for Special Surgery (HSS) scores, and range of motions (ROMs) were evaluated and analyzed at the postoperative follow-up of 3 months and 2 years. From our results, BME was highly correlated to poor outcome in patients with UKA. At follow-up of 3 months, BME influenced the clinical outcome of UKA at an early postoperative stage in terms of VAS scores, HSS scores, and ROMs. At the final follow-up of 2 years, the clinical outcome was improved in terms of HSS score, although the anterior knee pain and active ROMs were still worse than that of patients without BME. In conclusion, there was no significant difference in clinical outcomes in patients without BME regardless of PF OA. However, the condition of BME should be taken serious consideration because of its indication of an adverse effect on the outcome after UKA.