Unicompartmental knee arthroplasty versus total knee arthroplasty in the same patient with bilateral unicompartment knee osteoarthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty (UKA) has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, few complications and high patient satisfaction. However, it has not been extensively accepted by orthopedic surgeons. OBJECTIVE:To investigate the clinical effect and imaging changes of UKA versus total knee arthroplasty(TKA)in the same patient with bilateral unicompartment knee osteoarthritis. METHODS: A total of 38 patients with bilateral unicompartment knee osteoarthritis undergoing UKA and TKA were selected, and all the cases were performed by the same surgeon. Among them, 10 cases were replaced at the same time, and 28 cases were in staging surgery. The clinical data of the patients were collected, including the preoperative and postoperative Knee Society Score sores, the range of motion of the knee, and limb alignment, and postoperative complications. Comparison between bilateral knee joints was conducted by paired t test. RESULTS AND CONCLUSION: (1) All patients were followed up for 3-36 months, and no aseptic prosthesis loosening, unexplained pain or other complications occurred. (2) The postoperative Knee Society Score sores in UKA and TKA were significantly higher than those before surgery, and the scores did not differ significantly between UKA and TKA at each time point (P > 0.05). (3) The range of motion of the knee in the UKA group was significantly larger than that in the TKA group at the last follow-up postoperatively (P < 0.05). (4) The limb alignment was improved in both groups, which showed no significant difference at different time points (P > 0.05). (5) Totally 20 patients felt preference for UKA, 18 patients preferred TKA, and most patients were satisfied with the surgical efficacy. (6)There were no significant differences in the Knee Society Score, range of motion of the knee, hip-knee-ankle angle and femorotibial angle at the last follow-up between staging and same time arthroplasties. (7)These findings imply that for patients with bilateral unicompartment knee osteoarthritis, both UKA and TKA can correct the lower limb force line, correct the limb alignment similarly, but UKA holds advantages in less trauma, high patient's satisfaction, and good functional recovery, so it should be selected firstly. Notably, staging or same time surgery makes no effect on the clinical effectiveness.