Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2015

Open Access 01-12-2015 | Research article

Comparison of clinical outcomes between total knee arthroplasty and unicompartmental knee arthroplasty for osteoarthritis of the knee: a retrospective analysis of preoperative and postoperative results

Authors: Akira Horikawa, Naohisa Miyakoshi, Yoichi Shimada, Hiroyuki Kodama

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2015

Login to get access

Abstract

Background

Excellent results have recently been reported for both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA), but there have been few reports about which has a better long-term outcome. The preoperative and postoperative results of TKA and UKA for osteoarthritis of the knee were thus compared.

Methods

The results of 48 patients who underwent TKA and 25 patients who underwent UKA were evaluated based on clinical scores and survivorship in the middle long-term period. Preoperative, latest postoperative, and changes in the femoro-tibial angle (FTA), range of motion (ROM), Japanese Orthopedic Association score (JOA score), and Japanese Knee Osteoarthritis Measure (JKOM) were compared. The patients’ mean age was 73 years. The mean follow-up period was 9 years (TKA: mean, 10.5 years; range, 7–12 years; UKA: mean, 9 years; range, 6–11 years).

Results

Preoperative FTA and ROM were significantly higher in the UKA group than in the TKA group. Total changes in all scores were similar among the two groups, as were changes in scores for all JOA and JKOM domains. The cumulative revision rate was higher for UKA than for TKA (7 versus 4 %). Kaplan-Meier survivorship at 10 years was 84 % for UKA and 92 % for TKA.

Conclusions

This clinical study found no significant differences between TKA and UKA, except in long-term survivorship.
Literature
1.
go back to reference Aglietti P, Buzzi R, De Felice R, Giron F. The Insall-Burstein total knee replacement in osteoarthritis: a 10-year minimum follow-up. J Arthroplasty. 1999;14:560–5.CrossRefPubMed Aglietti P, Buzzi R, De Felice R, Giron F. The Insall-Burstein total knee replacement in osteoarthritis: a 10-year minimum follow-up. J Arthroplasty. 1999;14:560–5.CrossRefPubMed
2.
go back to reference Lewold S, Robertsson O, Knutson K, Lidgren L. Revision of unicompartmental knee arthroplasty: outcome in 1,135 cases from the Swedish Knee Arthroplasty study. Acta Orthop Scand. 1998;69:469–74.CrossRefPubMed Lewold S, Robertsson O, Knutson K, Lidgren L. Revision of unicompartmental knee arthroplasty: outcome in 1,135 cases from the Swedish Knee Arthroplasty study. Acta Orthop Scand. 1998;69:469–74.CrossRefPubMed
3.
go back to reference Colizza WA, Insall JN, Scuderi GR. The posterior stabilized total knee prosthesis: assessment of polyethylene damage and osteolysis after a ten-year-minimum follow-up. J Bone Joint Surg Am. 1995;77:1713–20.PubMed Colizza WA, Insall JN, Scuderi GR. The posterior stabilized total knee prosthesis: assessment of polyethylene damage and osteolysis after a ten-year-minimum follow-up. J Bone Joint Surg Am. 1995;77:1713–20.PubMed
4.
go back to reference Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D. Total knee replacement in young, active patients: long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997;79:575–82.PubMed Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D. Total knee replacement in young, active patients: long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997;79:575–82.PubMed
5.
go back to reference Fetzer GB, Callaghan JJ, Templeton JE, Goetz DD, Sullivan PM, Kelley SS. Posterior cruciate-retaining modular total knee arthroplasty: a 9- to 12-year follow-up investigation. J Arthroplasty. 2002;17:961–6.CrossRefPubMed Fetzer GB, Callaghan JJ, Templeton JE, Goetz DD, Sullivan PM, Kelley SS. Posterior cruciate-retaining modular total knee arthroplasty: a 9- to 12-year follow-up investigation. J Arthroplasty. 2002;17:961–6.CrossRefPubMed
6.
go back to reference Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res. 1997;345:79–86.PubMed Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. Clin Orthop Relat Res. 1997;345:79–86.PubMed
7.
go back to reference Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW. Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res. 2012;470:84–90.PubMedCentralCrossRefPubMed Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW. Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res. 2012;470:84–90.PubMedCentralCrossRefPubMed
8.
go back to reference Bruni D, Iacono I, Raspugli G, Zaffagnini S. Is unicompartmental arthroplasty an acceptable option for spontaneous osteonecrosis of the knee? Clin Orthop Relat Res. 2012;470:1442–51.PubMedCentralCrossRefPubMed Bruni D, Iacono I, Raspugli G, Zaffagnini S. Is unicompartmental arthroplasty an acceptable option for spontaneous osteonecrosis of the knee? Clin Orthop Relat Res. 2012;470:1442–51.PubMedCentralCrossRefPubMed
9.
go back to reference Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, et al. Ten year survivorship after cemented and uncemented medial uniglide unicompartmental knee arthroplasties. Knee. 2014;21:964–70.CrossRefPubMed Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, et al. Ten year survivorship after cemented and uncemented medial uniglide unicompartmental knee arthroplasties. Knee. 2014;21:964–70.CrossRefPubMed
10.
go back to reference Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs. fixed bearing unicondylar arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13:365–70.CrossRefPubMed Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs. fixed bearing unicondylar arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13:365–70.CrossRefPubMed
11.
go back to reference Tomihisa K. The therapy criteria of osteoarthritis of knee. Nippon Seikeigekagakkaisi. 1988;62:901–2 (In Japanese). Tomihisa K. The therapy criteria of osteoarthritis of knee. Nippon Seikeigekagakkaisi. 1988;62:901–2 (In Japanese).
12.
go back to reference Akai M, Doi T, Fujino K, Iwaya T, Kurosawa H, Nasu T. An outcome measure for Japanese people with knee osteoarthritis. J Rheum. 2005;32:1524–32.PubMed Akai M, Doi T, Fujino K, Iwaya T, Kurosawa H, Nasu T. An outcome measure for Japanese people with knee osteoarthritis. J Rheum. 2005;32:1524–32.PubMed
13.
go back to reference Rosenberg AG. Surgical technique of posterior cruciate sacrificing, and preserving total knee arthroplasty in total knee arthroplasty. In: Rand JA, editor. Total Knee Arthroplasty. New York: Raven; 1993. p. 115–53. Rosenberg AG. Surgical technique of posterior cruciate sacrificing, and preserving total knee arthroplasty in total knee arthroplasty. In: Rand JA, editor. Total Knee Arthroplasty. New York: Raven; 1993. p. 115–53.
14.
go back to reference Insall J. Unicondylar knee replacement. Clin Orthop Relat Res. 1976;120:83–5.PubMed Insall J. Unicondylar knee replacement. Clin Orthop Relat Res. 1976;120:83–5.PubMed
15.
go back to reference MacDonald SJ, Charron KD, Bourne RB, Naudie DD, McCalden RW, Rorabeck CH. The John Insall Award. Gender-specific total knee replacement: prospectively collected clinical outcomes. Clin Orthop Relat Res. 2008;466:2612–6.PubMedCentralCrossRefPubMed MacDonald SJ, Charron KD, Bourne RB, Naudie DD, McCalden RW, Rorabeck CH. The John Insall Award. Gender-specific total knee replacement: prospectively collected clinical outcomes. Clin Orthop Relat Res. 2008;466:2612–6.PubMedCentralCrossRefPubMed
16.
go back to reference Rajgopal V, Bourne RB, Chesworth BM, MacDonald SJ, McCalden RW, Rorabeck CH. The impact of morbid obesity on patient outcomes after total knee arthroplasty. J Arthroplasty. 2008;23:795–800.CrossRefPubMed Rajgopal V, Bourne RB, Chesworth BM, MacDonald SJ, McCalden RW, Rorabeck CH. The impact of morbid obesity on patient outcomes after total knee arthroplasty. J Arthroplasty. 2008;23:795–800.CrossRefPubMed
17.
go back to reference Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ. Unicompartmental or total knee arthroplasty? Results from a matched study. Clin Orthop Relat Res. 2006;451:101–6.CrossRefPubMed Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ. Unicompartmental or total knee arthroplasty? Results from a matched study. Clin Orthop Relat Res. 2006;451:101–6.CrossRefPubMed
18.
go back to reference Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW. Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee. 2007;14:212–7.CrossRefPubMed Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW. Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee. 2007;14:212–7.CrossRefPubMed
19.
go back to reference Naudie D, Guerin J, Parker DA, Bourne RB, Rorabeck CH. Medial unicompartment knee arthroplasty with the Miller-Galante prosthesis. J Bone Joint Surg Am. 2004;86:1931–5.PubMed Naudie D, Guerin J, Parker DA, Bourne RB, Rorabeck CH. Medial unicompartment knee arthroplasty with the Miller-Galante prosthesis. J Bone Joint Surg Am. 2004;86:1931–5.PubMed
20.
go back to reference Newman JH, Ackroyd CE, Shah NA. Unicompartmental or total knee replacement? Five-year results of a prospective randomized trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br. 1998;80:862–5.CrossRefPubMed Newman JH, Ackroyd CE, Shah NA. Unicompartmental or total knee replacement? Five-year results of a prospective randomized trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br. 1998;80:862–5.CrossRefPubMed
21.
go back to reference Dalury DD, Kelley TC, Adams MJ. Medial UKA: favorable mid-term results in middle-aged patients. J Knee Surg. 2013;26:133–8.PubMed Dalury DD, Kelley TC, Adams MJ. Medial UKA: favorable mid-term results in middle-aged patients. J Knee Surg. 2013;26:133–8.PubMed
22.
go back to reference Gill GS, Joshi AB. Long-term results of kinematic condylar knee replacement: an analysis of 404 knees. J Bone Joint Surg Br. 2001;88:355–8.CrossRef Gill GS, Joshi AB. Long-term results of kinematic condylar knee replacement: an analysis of 404 knees. J Bone Joint Surg Br. 2001;88:355–8.CrossRef
23.
go back to reference Keating EM, Meding JB, Faris PM, Ritter MA. Long-term follow up of nonmodular knee replacements. Clin Orthop Relat Res. 2002;404:34–9.CrossRefPubMed Keating EM, Meding JB, Faris PM, Ritter MA. Long-term follow up of nonmodular knee replacements. Clin Orthop Relat Res. 2002;404:34–9.CrossRefPubMed
25.
go back to reference Ritter MA, Berend ME, Meding JB, Keating EM, Faris PM, Crites BM. Long-term follow up of anatomic graduated components posterior cruciate-retaining total knee replacement. Clin Orthop Relat Res. 2001;388:51–7.CrossRefPubMed Ritter MA, Berend ME, Meding JB, Keating EM, Faris PM, Crites BM. Long-term follow up of anatomic graduated components posterior cruciate-retaining total knee replacement. Clin Orthop Relat Res. 2001;388:51–7.CrossRefPubMed
26.
go back to reference Suggs JF, Li G, Park SE, Sultan PG, Rubash HE, Freigerg AA. Knee biomechanics after UKA and its relation to the ACL—a robotic investigation. J Orthop Res. 2006;24:588–94.CrossRefPubMed Suggs JF, Li G, Park SE, Sultan PG, Rubash HE, Freigerg AA. Knee biomechanics after UKA and its relation to the ACL—a robotic investigation. J Orthop Res. 2006;24:588–94.CrossRefPubMed
27.
go back to reference Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG. Function analysis of cemented unicompartmental knee arthroplasty. J Arthroplasty. 1996;11:553–9.CrossRefPubMed Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG. Function analysis of cemented unicompartmental knee arthroplasty. J Arthroplasty. 1996;11:553–9.CrossRefPubMed
Metadata
Title
Comparison of clinical outcomes between total knee arthroplasty and unicompartmental knee arthroplasty for osteoarthritis of the knee: a retrospective analysis of preoperative and postoperative results
Authors
Akira Horikawa
Naohisa Miyakoshi
Yoichi Shimada
Hiroyuki Kodama
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2015
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-015-0309-2

Other articles of this Issue 1/2015

Journal of Orthopaedic Surgery and Research 1/2015 Go to the issue