Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 4/2020

25.02.2020 | Knee Arthroplasty

Unicondylar vs. total knee arthroplasty in medial osteoarthritis: a retrospective analysis of registry data and functional outcome

verfasst von: Michael Liebensteiner, Paul Köglberger, Alexander Ruzicka, Johannes M. Giesinger, Wilhelm Oberaigner, Martin Krismer

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 4/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

It was the aim of our study to compare the functional outcome (WOMAC score, range of motion) achieved with unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA). It was hypothesized that UKA and TKA would differ with regard to the WOMAC function scale (hypothesis 1) and the WOMAC total scale (hypothesis 2). It was assumed that the groups would differ with respect to changes in range of motion (ROM) over time (hypothesis 3).

Methods

A retrospective comparative study was conducted to analyze data available from the federal state's Arthroplasty Registry (WOMAC score) and from clinical routine (ROM). Patients who underwent UKA or TKA between 2008 and 2015 were considered. ANOVAs for repeated measurements were applied, adjusted for age, to test hypotheses 1–3.

Results

The UKA group was comprised of 112 patients (age 65, BMI 29). The TKA group included 330 cases (age 69, BMI 29). Regarding hypothesis 1, the amount of improvement in WOMAC function was not influenced by the surgical group (no significant group*time interactions, p = 0.608). Similarly, for hypothesis 2, the amount of improvement in the WOMAC total score was not influenced by the surgical group (no significant group*time interactions, p = 0.392). Regarding hypothesis 3, we found no significant group*time interaction for the ROM data (p = 0.731).

Conclusions

On the basis of our findings, it is concluded that whether knee osteoarthritis is treated with either medial UKA or TKA has no influence on the WOMAC total score or any of the WOMAC subscales. It has no effect on early or late ROM gain
Literatur
1.
Zurück zum Zitat Ali AM, Pandit H, Liddle AD, Jenkins C, Mellon S, Dodd CA et al (2016) Does activity affect the outcome of the Oxford unicompartmental knee replacement? Knee 23:327–330CrossRef Ali AM, Pandit H, Liddle AD, Jenkins C, Mellon S, Dodd CA et al (2016) Does activity affect the outcome of the Oxford unicompartmental knee replacement? Knee 23:327–330CrossRef
2.
Zurück zum Zitat Baker PN, Petheram T, Jameson SS, Avery PJ, Reed MR, Gregg PJ et al (2012) Comparison of patient-reported outcome measures following total and unicondylar knee replacement. J Bone Jt Surg Br Vol 94:919–927CrossRef Baker PN, Petheram T, Jameson SS, Avery PJ, Reed MR, Gregg PJ et al (2012) Comparison of patient-reported outcome measures following total and unicondylar knee replacement. J Bone Jt Surg Br Vol 94:919–927CrossRef
3.
Zurück zum Zitat Dalury DF, Fisher DA, Adams MJ, Gonzales RA (2009) Unicompartmental knee arthroplasty compares favorably to total knee arthroplasty in the same patient. Orthopedics 32(4), pii: orthosupersite.com/view.asp?rID=38057 Dalury DF, Fisher DA, Adams MJ, Gonzales RA (2009) Unicompartmental knee arthroplasty compares favorably to total knee arthroplasty in the same patient. Orthopedics 32(4), pii: orthosupersite.com/view.asp?rID=38057
4.
Zurück zum Zitat Ho JC, Stitzlein RN, Green CJ, Stoner T, Froimson MI (2016) Return to sports activity following UKA and TKA. J Knee Surg 29:254–259PubMed Ho JC, Stitzlein RN, Green CJ, Stoner T, Froimson MI (2016) Return to sports activity following UKA and TKA. J Knee Surg 29:254–259PubMed
5.
Zurück zum Zitat Hopper GP, Leach WJ (2008) Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc 16:973–979CrossRef Hopper GP, Leach WJ (2008) Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc 16:973–979CrossRef
6.
Zurück zum Zitat Horikawa A, Miyakoshi N, Shimada Y, Kodama H (2015) 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. J Orthop Surg Res 10:168CrossRef Horikawa A, Miyakoshi N, Shimada Y, Kodama H (2015) 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. J Orthop Surg Res 10:168CrossRef
7.
Zurück zum Zitat Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW (2007) Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee 14:212–217CrossRef Isaac SM, Barker KL, Danial IN, Beard DJ, Dodd CA, Murray DW (2007) Does arthroplasty type influence knee joint proprioception? A longitudinal prospective study comparing total and unicompartmental arthroplasty. Knee 14:212–217CrossRef
8.
Zurück zum Zitat Jones GG, Kotti M, Wiik AV, Collins R, Brevadt MJ, Strachan RK et al (2016) Gait comparison of unicompartmental and total knee arthroplasties with healthy controls. Bone Jt J 98-B:16–21CrossRef Jones GG, Kotti M, Wiik AV, Collins R, Brevadt MJ, Strachan RK et al (2016) Gait comparison of unicompartmental and total knee arthroplasties with healthy controls. Bone Jt J 98-B:16–21CrossRef
9.
Zurück zum Zitat Krych AJ, Reardon P, Sousa P, Pareek A, Stuart M, Pagnano M (2017) Unicompartmental knee arthroplasty provides higher activity and durability than valgus-producing proximal tibial osteotomy at 5–7 years. J Bone Jt Surg Am Vol 99:113–122CrossRef Krych AJ, Reardon P, Sousa P, Pareek A, Stuart M, Pagnano M (2017) Unicompartmental knee arthroplasty provides higher activity and durability than valgus-producing proximal tibial osteotomy at 5–7 years. J Bone Jt Surg Am Vol 99:113–122CrossRef
10.
Zurück zum Zitat Liddle AD, Pandit H, Judge A, Murray DW (2015) Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Jt J 97-B:793–801CrossRef Liddle AD, Pandit H, Judge A, Murray DW (2015) Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Jt J 97-B:793–801CrossRef
11.
Zurück zum Zitat Lum ZC, Lombardi AV, Hurst JM, Morris MJ, Adams JB, Berend KR (2016) Early outcomes of twin-peg mobile-bearing unicompartmental knee arthroplasty compared with primary total knee arthroplasty. Bone Jt J 98-B:28–33CrossRef Lum ZC, Lombardi AV, Hurst JM, Morris MJ, Adams JB, Berend KR (2016) Early outcomes of twin-peg mobile-bearing unicompartmental knee arthroplasty compared with primary total knee arthroplasty. Bone Jt J 98-B:28–33CrossRef
12.
Zurück zum Zitat Lygre SH, Espehaug B, Havelin LI, Furnes O, Vollset SE (2010) Pain and function in patients after primary unicompartmental and total knee arthroplasty. J Bone Jt Surg Am Vol 92:2890–2897CrossRef Lygre SH, Espehaug B, Havelin LI, Furnes O, Vollset SE (2010) Pain and function in patients after primary unicompartmental and total knee arthroplasty. J Bone Jt Surg Am Vol 92:2890–2897CrossRef
13.
Zurück zum Zitat Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470:84–90CrossRef Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW (2012) Unicompartmental versus total knee arthroplasty database analysis: is there a winner? Clin Orthop Relat Res 470:84–90CrossRef
14.
Zurück zum Zitat Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Jt Surg Br Vol 91:52–57CrossRef Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Jt Surg Br Vol 91:52–57CrossRef
15.
Zurück zum Zitat Noticewala MS, Geller JA, Lee JH, Macaulay W (2012) Unicompartmental knee arthroplasty relieves pain and improves function more than total knee arthroplasty. J Arthroplast 27:99–105CrossRef Noticewala MS, Geller JA, Lee JH, Macaulay W (2012) Unicompartmental knee arthroplasty relieves pain and improves function more than total knee arthroplasty. J Arthroplast 27:99–105CrossRef
16.
Zurück zum Zitat Petersen W, Metzlaff S (2016) Open wedge high tibial osteotomy (HTO) versus mobile bearing unicondylar medial joint replacement: 5 years results. Arch Orthop Trauma Surg 136:983–989CrossRef Petersen W, Metzlaff S (2016) Open wedge high tibial osteotomy (HTO) versus mobile bearing unicondylar medial joint replacement: 5 years results. Arch Orthop Trauma Surg 136:983–989CrossRef
17.
Zurück zum Zitat Sweeney K, Grubisic M, Marra CA, Kendall R, Li LC, Lynd LD (2013) Comparison of HRQL between unicompartmental knee arthroplasty and total knee arthroplasty for the treatment of osteoarthritis. J Arthroplast 28:187–190CrossRef Sweeney K, Grubisic M, Marra CA, Kendall R, Li LC, Lynd LD (2013) Comparison of HRQL between unicompartmental knee arthroplasty and total knee arthroplasty for the treatment of osteoarthritis. J Arthroplast 28:187–190CrossRef
18.
Zurück zum Zitat Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2014) Total versus unicompartmental knee replacement for isolated lateral osteoarthritis: a matched-pairs study. Int Orthop 38:2259–2264CrossRef Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2014) Total versus unicompartmental knee replacement for isolated lateral osteoarthritis: a matched-pairs study. Int Orthop 38:2259–2264CrossRef
19.
Zurück zum Zitat Yim JH, Song EK, Seo HY, Kim MS, Seon JK (2013) Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplast 28:243–247CrossRef Yim JH, Song EK, Seo HY, Kim MS, Seon JK (2013) Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplast 28:243–247CrossRef
20.
Zurück zum Zitat Braito M, Giesinger JM, Fischler S, Koller A, Niederseer D, Liebensteiner MC (2016) Knee extensor strength and gait characteristics after minimally invasive unicondylar knee arthroplasty vs minimally invasive total knee arthroplasty: a nonrandomized controlled trial. J Arthroplast 31:1711–1716CrossRef Braito M, Giesinger JM, Fischler S, Koller A, Niederseer D, Liebensteiner MC (2016) Knee extensor strength and gait characteristics after minimally invasive unicondylar knee arthroplasty vs minimally invasive total knee arthroplasty: a nonrandomized controlled trial. J Arthroplast 31:1711–1716CrossRef
21.
Zurück zum Zitat Marx RG, Jones EC, Atwan NC, Closkey RF, Salvati EA, Sculco TP (2005) Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Jt Surg Am Vol 87:1999–2005CrossRef Marx RG, Jones EC, Atwan NC, Closkey RF, Salvati EA, Sculco TP (2005) Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Jt Surg Am Vol 87:1999–2005CrossRef
22.
Zurück zum Zitat Na SE, Ha CW, Lee CH (2012) A new high-flexion knee scoring system to eliminate the ceiling effect. Clin Orthop Relat Res 470:584–593CrossRef Na SE, Ha CW, Lee CH (2012) A new high-flexion knee scoring system to eliminate the ceiling effect. Clin Orthop Relat Res 470:584–593CrossRef
Metadaten
Titel
Unicondylar vs. total knee arthroplasty in medial osteoarthritis: a retrospective analysis of registry data and functional outcome
verfasst von
Michael Liebensteiner
Paul Köglberger
Alexander Ruzicka
Johannes M. Giesinger
Wilhelm Oberaigner
Martin Krismer
Publikationsdatum
25.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 4/2020
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-020-03377-8

Weitere Artikel der Ausgabe 4/2020

Archives of Orthopaedic and Trauma Surgery 4/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.