Unicompartmental Versus Total Knee Arthroplasty Database Analysis: Is There a Winner?

Abstract

Background TKA and unicompartmental knee arthroplasty (UKA) are both utilized to treat unicompartmental knee arthrosis. While some surgeons assume UKA provides better function than TKA, this assumption is based on greater final outcome scores rather than on change in scores and many patients with UKA have higher preoperative scores. Questions/purposes We therefore asked whether TKA would demonstrate (1) better change in clinical outcome scores from preoperative to postoperative states and (2) better survivorship than UKA. Methods We evaluated 4087 patients with 5606 TKAs and 179 patients with 279 UKAs performed between 1978 and 2009. Patients with TKA were older and heavier than patients with UKA (mean age, 68 versus 66 years; mean BMI, 32 versus 29). We compared preoperative, latest postoperative, and change in Knee Society Clinical Rating System (KSCRS), SF-12, and WOMAC scores. Minimum followup was 2 years (UKA: mean, 7 years; range, 2.0-23 years; TKA: mean, 6.5 years; range, 2.0-33 years). Preoperative outcome measure scores (WOMAC, SF-12, KSCRS) were higher in the UKA group. Results Patients with UKA had higher postoperative KSCRS and SF-12 mental scores. Changes in score for all WOMAC domains were similar between groups. Total KSCRS changes in score were similar between groups, although patients with TKA had higher knee scores (49 versus 43) but lower function scores than UKA (21 versus 26). Cumulative revision rate was higher for UKA than for TKA (13% versus 7%). Kaplan-Meier survivorship at 5 and 10 years was 95% and 90%, respectively, for UKA and 98% and 95%, respectively, for TKA. Conclusions While patients with UKA had higher preand postoperative scores than patients with TKA, the changes in scores were similar in both groups and survival appeared higher in patients with TKA.

Better Quality of Life After Medial Versus Lateral Unicondylar Knee Arthroplasty

“…Therefore, the external validity of the study is limited. However, the HRQoL outcomes in our study compare well with those of other studies after UKA [15,21,25]. Therefore, it appears reasonable to assume the results of our large cohort could be transferable to some extent to the population having UKAs.…”

Unicompartmental knee arthroplasty is effective: ten year results

“…Many authors have reported similar ten year survivorship rates between UKA and TKA, but many others different rates [7,10,23,24]. In this study, a TKA control group was not presented, as the authors believe that indications to perform UKA or TKA could be quite different.…”

“…It is widely accepted that UKA has a low morbidity with a low risk of serious complications, including infection [7,8]. Additionally, the minimally invasive approach for UKA provides excellent functional results and fast recovery [9,10]. Despite this, results of knee replacement registries still show relatively high and failure rates for UKA, especially when compared with traditional TKA [11].…”

Artroplastia unicompartimental do joelho: perspectivas e tendências atuais no Brasil

“…A study demonstrated the presence of a wider range of motion postoperatively and shorter hospitalization time in patients submitted to partial knee arthroplasties (25) . Another study published recently did not show any differences between the results obtained after treatment with total and partial knee arthroplasties (26) .…”