Unicompartmental or total knee replacement

Abstract

Between 1989 and 1992 we had 102 knees suitable for unicompartmental knee replacement (UKR). They were randomised to receive either a St Georg Sled UKR or a Kinematic modular total knee replacement (TKR). The early results demonstrated that the UKR group had less complications and more rapid rehabilitation than the TKR group. At five years there were an equal number of failures in the two groups but the UKR group had more excellent results and a greater range of movement. The cases were reviewed by a research nurse at 8, 10 and 12 years after operation. We report the outcome at 15 years follow-up. A total of 43 patients (45 knees) died with their prosthetic knees intact. Throughout the review period the Bristol knee scores of the UKR group have been better and at 15 years 15 (71.4%) of the surviving UKRs and 10 (52.6%) of the surviving TKRs had achieved an excellent score. The 15 years survivorship rate based on revision or failure for any reason was 24 (89.8%) for UKR and 19 (78.7%) for TKR. During the 15 years of the review four UKRs and six TKRs failed. The better early results with UKR are maintained at 15 years with no greater failure rate. The median Bristol knee score of the UKR group was 91.1 at five years and 92 at 15 years, suggesting little functional deterioration in either the prosthesis or the remainder of the joint. These results justify the increased use of UKR.

Time-dependent improvement in functional outcome following Oxford medial unicompartmental knee arthroplasty

“…We used the Norwegian version of the KOOS, which was published by Lygre and coworkers (2007). To our knowledge, only a few studies on functional results after UKR have involved follow-up at multiple time points (Kleijn et al 2007, Newman et al 2009), and none of them have used self-reported questionnaires. One of the strengths of our study is that we have included both short- and medium-term evaluations, which are necessary to establish a true timeline of functional recovery.…”

“…Studies comparing UKR to total knee replacement (TKR) have shown faster recovery, shorter hospital stay, more normal kinematics, better range of motion, less blood loss, fewer thromboembolic incidents, and fewer surgical site infections (Li et al 2006, Walton et al 2006, Furnes et al 2007, Lombardi et al 2009, Newman et al 2009). Survival rates as high as 96–98% at 10 years have been reported in single-center studies (Murray et al 1998, Pandit et al 2011), whereas in studies from national arthroplasty registers 10-year survival rates have been reported to be as low as 80% (Furnes et al 2007, Koskinen et al 2008).…”

Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial

“…However, no consistent results have been shown in these published randomized trials [5,20,23]. To the best of our knowledge, one meta-analysis [28] that compares UKA with TKA has been published over the past few years that pooled only one RCT study [19,20] with 6 other prospective cohort studies [2,6,12,15,17,27], and found that there was no clinically relevant or statistically significant improvement in UKA when compared to TKA. However, this meta-analysis did not consider sources of heterogeneity (e.g., preoperative range of motion, age, sex, and body mass index), and publication bias was not assessed.…”

Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term

“…There have been impressive survivorship studies, from both originator and non originator data, for the Oxford Unicompartmental Knee prosthesis, with rates of 94-100% at 10 years, and 95% at 14 years [1-5] and 90% at 15 years [6]. There are fewer studies describing the functional outcomes of this prosthesis [7-9].…”