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Randomized Controlled Trial
. 2021 Jun 23;11(6):e046731.
doi: 10.1136/bmjopen-2020-046731.

Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial

Jani Knifsund  1   2 , Tuukka Niinimaki  3 , Heikki Nurmi  4 , Alar Toom  4 , Hannes Keemu  5 , Inari Laaksonen  5   2 , Matti Seppänen  5 , Antti Liukas  6 , Konsta Pamilo  4 , T Vahlberg  2 , Ville Äärimaa  5 , K T Mäkelä  5   2   7
Affiliations
Randomized Controlled Trial

Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial

Jani Knifsund et al. BMJ Open. .

Abstract

Objective: The primary objective of the trial was to assess the clinical effectiveness of medial unicompartmental knee arthroplasty versus total knee arthroplasty in patients with isolated medial osteoarthritis of the knee.

Design: Prospective, randomised, 2 years, assessor-blind, multicentre, superiority trial.

Setting: The patients were enrolled between December 2015 and May 2018 from the outpatient clinics of three public high-volume arthroplasty hospitals (Finland).

Participants: We recruited 143 patients with symptomatic-isolated medial osteoarthritis of the knee needing an arthroplasty procedure. All the patients were suitable for both unicompartmental and total knee arthroplasties. Population was selected as the end-stage-isolated medial osteoarthritis.

Interventions: All patients, randomized 1:1, received a medial unicompartmental arthroplasty or a total knee arthroplasty through a similar midline skin incision. Patients were blinded to the type of arthroplasty for the whole 2 years of follow-up.

Main outcome measures: Primary outcome measure was between-group differences in the Oxford Knee Score (OKS) and secondary outcome Knee injury and Osteoarthritis Score (KOOS) at 2 years postoperatively. The changes within and between the groups were analysed with analysis of variance for repeated measurements.

Results: The primary outcome was comparable for medial unicompartmental arthroplasty and total knee arthroplasty at 2 years. The mean difference in the OKS between the groups was 1.6 points (95% CI -0.7 to 3.9). In the KOOS subscales, the mean difference between the groups was 0.1 points (95% CI -4.8 to 5.0) for pain, 7.8 points (95% CI 1.5 to 14.0) for symptoms, 4.3 points (95% CI -0.6 to 9.2) for function in daily living, 4.3 points (95% CI -3.0 to 11.6) for function in sports, and 2.1 points (95% CI -4.8 to 9.1) for knee-related quality of life.

Conclusions: The recovery after unicompartmental knee arthroplasty was faster compared with total knee arthroplasty, but unicompartmental arthroplasty did not provide a better patient-reported outcome at 2 years.

Trial registration number: NCT02481427.

Keywords: adult orthopaedics; knee; musculoskeletal disorders; orthopaedic & trauma surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart. *Included to final analysis according to intention-to-treat principles.
Figure 2
Figure 2
Primary and secondary outcomes in the unicompartmental knee arthroplasty group and the total knee arthroplasty group. Values are means with 95% CIs. | | Unicompartmental knee. | | Arthroplasty total knee arthroplasty. KOOS, Knee injury and Osteoarthritis Score.
See this image and copyright information in PMC

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