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Unicompartmental Knee Arthroplasty Compares Favorably to Total
Knee Arthroplasty in the Same Patient
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http://www.orthosupersite.com/view.asp?rID=38057
By David F. Dalury, MD; David A. Fisher, MD; Mary Jo
Adams, BSN, RN; Ricardo A. Gonzales, MD
ORTHOPEDICS 2009; 32:253
Abstract There are several
surgical management options for medial knee arthritis, and it is
often difficult to decide whether a unicompartmental knee
arthroplasty (UKA) or total knee arthroplasty (TKA) is appropriate.
Few studies have compared UKAs and TKAs in the same patient. We
identified 23 patients with osteoarthritis who had a TKA on one side
and a UKA on the other. The preoperative values of the 2 knees were
not statistically different. Strict criteria were used to determine
whether a UKA could be performed (functional anterior cruciate
ligament, minimal deformity, and minimum changes in other
compartments). Preoperative radiographs were reviewed to confirm
that the knee undergoing TKA had medial compartment disease only.
Knee Society scores, radiographic analysis, and patient preferences
were recorded for all patients. Average follow-up was 46 months
(range, 7.2-148 months) and 42 months (range, 11.5-59.8 months) for
TKA and UKA, respectively.
We found little or no difference in outcomes between the 2
procedures, except for an improved range of motion with the UKA
compared with the TKA (123°±9° vs 119.8°±7°, respectively). Knee
Society scores improved from 45.9 to 89.7 in UKA and from 42.4 to
90.3 in TKA. Of the 23 patients, 11 expressed no preference between
either knee and 12 preferred the unicompartmental knee; no patient
preferred the total knee. With appropriate patient selection, UKAs
are a successful option for patients with osteoarthritis.
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