Residual Symptoms and Function After Unicompartmental and Total Knee Arthroplasty: Comparable to Normative Controls?

Abstract

Background: Whether patient-reported symptoms and function after total knee arthroplasty (TKA) and medial unicompartmental knee arthroplasty (UKA) compare favorably to similar individuals without a diagnosis of knee pathology has not been investigated.

Methods: A retrospective, multicenter study was designed in which 4 centers contributed patients between ages 18 and 80 years undergoing knee arthroplasty. Data were collected by an independent, third-party survey center that administered a questionnaire assessing patient satisfaction and function. The survey center identified a "control" population of the same age range using a "random digit dial call method" with no prior knee interventions or major problems with their knees limiting their activity. Comparisons were performed using multivariate logistic regression analyses accounting for differences in demographic variables among the 3 cohorts.

Results: Overall, 1456 TKAs, 476UKAs, and 409 controls were included for analysis. Controls reported a surprisingly high incidence of pain (30%), a limp (26%), stiffness (22%), and noise (21%) in their knee. However, the likelihood of reported noise (odds ratio [OR], 1.3), swelling (OR, 1.4), stiffness (OR, 1.8), and difficulty getting in and out of a chair (OR, 2.5) was increased after TKA vs controls (P < .001-.03). The likelihood of swelling (OR, 1.8), stiffness (OR, 1.5), and difficulty getting in and out of a chair (OR, 1.7) was increased after UKA vs controls (P = .002-.005).

Conclusion: When interviewed by an independent, third party, a substantial percentage of control patients reported the presence of knee symptoms, but to a lesser degree than patients after a knee arthroplasty.

Keywords: controls; function; symptoms; total knee arthroplasty; unicompartmental knee arthroplasty.