Satisfaction and Functional Outcomes in Unicompartmental Compared with Total Knee Arthroplasty

Abstract

Background: Unicompartmental and total knee arthroplasty (UKA and TKA) have demonstrated excellent mid- and long-term outcomes and have been compared in clinical series for decades; however, to our knowledge, no study has sufficiently matched UKA and TKA cohorts on preoperative osteoarthritis severity. The purpose of this study was to evaluate patient-reported outcomes of radiographically and demographically matched UKA and TKA cohorts. Methods: One hundred and thirty-five UKAs and 135 TKAs were matched by patient age, sex, body mass index, and American Society of Anesthesiologists Physical Status (ASA-PS) classification as well as preoperative osteoarthritis severity in medial and lateral tibiofemoral and patellofemoral compartments (Kellgren-Lawrence grading system). Patient-reported outcome measures for pain, function, activity level, and satisfaction were evaluated at minimum 1-year follow-up via components of the modern Knee Society Score, the University of California Los Angeles (UCLA) activity-level score, and a Likert satisfaction scale. Results: The patients in the UKA group reported significantly less pain, a higher activity level, and greater satisfaction while performing several functional activities and could walk for a longer amount of time before stopping due to knee discomfort compared with those in the TKA group (p ≤ 0.038). In addition, a greater proportion of patients in the UKA than in the TKA group were “satisfied or very satisfied” with their knee replacement surgery at minimum 1-year follow-up (90% versus 81%; p = 0.043). Conclusions: With minimum 1-year follow-up, patients who underwent UKA reported significantly higher function, less pain, and a greater level of patient satisfaction than a radiographically and demographically matched TKA cohort. Level of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

Popliteus Avulsion Fracture After Unicompartmental Arthroplasty

“…This case also illustrates the nuanced approach necessary to diagnose discomfort after arthroplasty procedures. Although patients undergoing UKA demonstrate greater levels of postoperative satisfaction than patients undergoing TKA, 10% of patients are not satisfied with the function of the operative knee 10 . Patients undergoing UKA face a significantly higher rate of revision surgery than patients undergoing TKA, which may be partially attributed to real or perceived contribution of the native patellofemoral and contralateral compartment to a patient’s continued discomfort 11 .…”

The Renaissance of Unicompartmental Knee Arthroplasty appears rational – A radiograph-based comparative Study on adverse Events and patient-reported Outcomes in 353 TKAs and 98 UKAs

“…A recent matched study of 135 TKAs and 135 UKAs reported both significantly improved pain and function, activity level, and satisfaction scores at 1-year follow-up for the UKA using the new Knee Society Score (KSS), the University of California Los Angeles (UCLA) activity-level score, and a Likert satisfaction scale respectively [ 31 ]. The Total Knee Questionnaire (TKQ) and the Forgotten Joint Score (FJS-12) have both demonstrated low ceiling effects in patient satisfaction measures and found UKA to be superior in this aspect [ 32 , 33 ].…”

Medial compartment osteoarthritis of the knee: a review of surgical options

“… 17 A recent radiographically matched cohort analysis gives further evidence towards improved PROMs in patients undergoing UKR, over those having TKR at one-year follow-up. 18 …”