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. 2023 Jan 25:10:1033830.
doi: 10.3389/fsurg.2023.1033830. eCollection 2023.

The mid-term outcomes of mobile bearing unicompartmental knee arthroplasty versus total knee arthroplasty in the same patient

Jinlong Ma  1 , Liang Zhang  2 , Cui Wang  1 , Kuishuai Xu  1 , Zhongkai Ren  1 , Tianrui Wang  3 , Yingze Zhang  1 , Xia Zhao  1 , Tengbo Yu  1
Affiliations

The mid-term outcomes of mobile bearing unicompartmental knee arthroplasty versus total knee arthroplasty in the same patient

Jinlong Ma et al. Front Surg. .

Abstract

Objective: To compare the mid-term outcomes of unicompartmental knee arthroplasty (UKA) that was performed in one knee and total knee arthroplasty (TKA) performed in the other knee in the same stage.

Methods: This is a retrospective study. A total of 63 patients (126 knees) scheduled for one-stage knee surgery due to osteoarthritis of both knees were selected, and all patients underwent one-stage mobile platform UKA and TKA of the other knee. Differences in general clinical data, functional recovery, complications, and prosthesis revision rates were assessed after UKA and TKA, respectively. The evaluation indicators for knee joint function recovery included the hospital for special surgery knee score (HSS), Joint Forgotten Score (JFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Visual analog scale (VAS). Patient preference between UKA and TKA was also recorded.

Results: During a mean follow-up of 76.95 months (range, 65.00 to 87.00 months), there were no significant differences in postoperative complications between the two groups (P = 0.299); however, the prosthesis revision rate was higher in the UKA group than in the TKA group (P = 0.023). The incision length, operation time, blood loss, and postoperative drainage volume in the UKA group were significantly (P < 0.001) lower than those in the TKA group: JFS, ROM, and VAS in the UKA group were higher than those in the TKA group (P < 0.001, P = 0.023, P = 0.032), HSS and KOOS in TKA group were significantly (P < 0.001) higher than those in UKA group. At the last follow-up, 40% and 24% of patients preferred TKA and UKA, respectively.

Conclusions: TKA was found to be superior to UKA in terms of HSS, KOOS, and VAS, while UKA had more significant advantages in terms of less surgical trauma, better ROM, and higher JFS. Complications were not different between groups, but UKA had a higher rate of prosthesis revision. After a follow-up of at least 5 years, more patients preferred TKA.

Keywords: complication; outcome; revision; total knee arthroplasty; unicompartmental knee arthroplasty.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Survival curves of kaplan-Meier prosthesis in two groups.
Figure 3
Figure 3
pre-operative (10 days) and post-operative (2 days) X-ray examinations of a 68-year-old women with bilateral osteoarthritis. (A) Anteroposterior position 10 days before operation. (B) Lateral position of right knee joint 10 days before operation. (C) Lateral position of left knee joint 10 days before operation. (D) Anteroposterior position 2 days after operation. (E) Lateral position of right knee joint 2 days after operation. (F) Lateral position of left knee joint 2 days after operation.
Figure 4
Figure 4
X-rays 5 months after UKA of the left knee and 3 days after conversion to TKA in a 65-year-old woman, White arrow: Poly backed out (A) Anteroposterior position of left knee joint 5 months after UKA, Poly backed out. (B) Lateral position of left knee joint 5 months after UKA. (C) The prosthesis of left knee joint was removed, and the surgical method was changed to TKA, anteroposterior position of left knee joint 3 days after TKA. (D) Lateral position of left knee joint 3 days after TKA.
See this image and copyright information in PMC

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