Summary: UKA has been considered to be the procedure with better functional outcomes traditionally but the current study demonstrates that when confounding factors are controlled, both TKA and UKA are effective, offer similar functional outcomes and result in similar improvement in sports participation.

Background

As many as 20% of patients who receive total knee arthroplasty (TKA) have isolated medial compartment osteoarthritis (OA) that could be treated by either TKA or unicompartmental knee arthroplasty (UKA) procedure. Both TKA and UKA are effective and offer similar clinical outcomes. After knee arthroplasty, patients have high expectations for the outcome and the success of the procedure is more and more evaluated by the ability to return to sports and physical activities. Therefore, patients must receive the most efficacious procedure for this condition.

Purpose

The purpose of this study was to compare (1) sports participation and type of sports activity between TKA and UKA patients (2) functional outcome and activity level between TKA and UKA (3) survivorship of the prosthesis in both groups. The hypothesis was that (1) both TKA and UKA groups will have a positive effect on sports participation with similar results (2) both the groups will have similar functional outcomes and activity levels (3) prosthesis survivorship will not be deteriorated by sports activities and survivorship will be similar in both the group.

Methods

Prospectively collected data were obtained from an arthroplasty database to identify patients who underwent primary TKA and UKA. Both the cohorts of TKA and UKA were matched, controlling for age, sex, BMI and preoperative patient-reported outcomes which include Oxford Knee score (OKS), Tegner activity level, and visual analog scale (VAS) for pain score. After matching the two groups, 287 TKA and 69 UKA cases were available to include in the study. Inclusion criteria were primary symptomatic medial compartment knee osteoarthritis (OA), age 50–90 years, and a minimum of 2-year follow-up after TKA and UKA. Patients with rheumatoid arthritis, Kellgren–Lawrence Grade 3–4 lateral compartment and patella-femoral OA, flexion contracture of more than 100, varus deformity more than 100, valgus more than 50, preoperative flexion less than 800, functionally deficient ACL, and revision knee surgery were excluded from the study. Patients were evaluated pre-and postoperatively at 2 years for sports participation and sports preference, patient-reported outcomes, activity levels and improvement in knee pain.

Results

The mean age of the TKA and UKA groups was 75.7 ± 8.1 and 74.2 ± 8.8, respectively. There was no significant difference between the two groups concerning the demographic variables. Significant improvement was noted in the weekly sports participation at the final follow-up compared to pre-operative sports participation in both the TKA and UKA groups (p<0.05). All patients were able to return to their desired sporting activity. No significant difference was noted between the two groups in sports participation pre-operatively and post-operatively (p>0.05). OKS, Tegner activity level and VAS for pain demonstrated a significant improvement from preoperative to 2 years postoperatively (p<0.05). However, preoperative and postoperative patient-reported outcomes did not differ significantly between the TKA and UKA groups (p>0.05). No case of revision surgery was found at a 2-year follow-up in both group.

Conclusion

UKA has been considered to be the procedure with better functional outcomes traditionally but the current study demonstrates that when confounding factors are controlled, both TKA and UKA are effective, offer similar functional outcomes and result in similar improvement in sports participation.
Level of evidence: Level III

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Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Hip-Knee-Ankle Angle Affects Medial and Lateral Tibiofemoral Compressive Forces More Significantly than Joint Line Obliquity in Patients Post Total Knee Arthroplasty ePoster Presentation David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN

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No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study

No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study

Background

Purpose

Methods

Results

Conclusion

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No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study

No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study

Background

Purpose

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content