A Comparative Study of Total Knee Arthroplasty and Unicondylar Knee Arthroplasty in the Treatment of Knee Osteoarthritis

Abstract

Objective: To compare the clinical efficacy of total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA) in the treatment of knee osteoarthritis (KOA).

Methods: A retrospective analysis was conducted on 30 patients admitted to the Department of Orthopaedics of Yijishan Hospital from 2020 to 2021. The patients were divided into UKA group (n = 15) and TKA group (control, n = 15). The intraoperative situation and postoperative clinical indicators of patients in the two groups were collected and compared, such as operation time, intraoperative blood loss, length of hospital stay, postoperative complications, and postoperative functional recovery. Postoperative functional recovery was investigated by the visual analogue pain scale (VAS), knee score scale (HSS), and knee range of motion (ROM) scores 5 days after surgery.

Results: Perioperative indexes in the UKA group were significantly lower than those in the TKA group, including operation time, intraoperative blood loss, first time going to the ground, and length of hospital stay. VAS, HSS, and ROM scores in the two groups were significantly improved after surgery compared with those before surgery. However, ROM scores in the UKA group were significantly better than in the TKA group. In terms of early postoperative complications, there was one case of venous thrombosis of lower limbs in the UKA group, while in the TKA group there was one case of delayed wound healing due to diabetes, and one case of deep infection.

Conclusion: Both UKA and TKA are very successful options for the treatment of KOA, but the use of UKA can promote the recovery of postoperative knee function, reduce postoperative complications, and achieve more satisfactory than expected results.

Figure 1

Patient, female, 53 years old. Pain and limited movement for more than 4 years, osteoarthritis of the right knee, unicondylar knee arthroplasty of the right knee. (a, b) Preoperative anteroposterior and lateral view of right knee joint. DR: the right knee joint was composed of complete bone, some bone edges showed hyperosteogeny, intercondylar protuberant hyperplasia, joint space existed, and there were no obvious abnormalities in surrounding soft tissues. Degeneration of the right knee. (c) Preoperative full-length X-ray of lower limbs showed narrowing of the medial joint space of the right knee joint and valgus deformity. (d, e) Anteroposterior and lateral radiographs of the right knee joint after partial replacement of the right knee joint: the replacement was in place and the joint space was called. (f) Postoperative full-length X-ray of lower limbs showed that the knee valgus deformity was corrected, the prosthesis was in a good position, and the force line of lower limbs was restored.

Figure 2

Patient, female, 67 years old. The pain in the right knee has been aggravated for more than 10 years. The osteoarthritis of the right knee joint was treated with total knee arthroplasty of the right knee. (a, b) The bone composition of the right knee joint is complete, the bone hyperplasia shadow can be seen at the bone edge, the intercondylar eminence hyperplasia, the joint space is under weighed, and there is no obvious abnormality in the surrounding soft tissue. Degeneration of the right knee. (c) Preoperative X-ray of the full length of the lower limb showed that the left knee was obviously valgus deformity and the patella was in the middle. (d, e) Replacement in place, joint space, etc. Changes after right knee arthroplasty. (f) The postoperative X-ray of the whole length of the lower limb showed that the valgus deformity of the knee joint was corrected, the prosthesis was in a good position, and the force line of the lower limb was restored.