Article
Lateral unicompartmental knee arthroplasty: Better functional results in comparison to total knee arthroplasty
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Published: | October 16, 2008 |
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Introduction: Unicompartmental knee Arthroplasty (UKA) is a commonly used and accepted treatment for Osteoarthritis (OA) in the medial compartment. However, there is still a reluctance to use this devise for lateral OA as they are thought to be not as much satisfactory. The procedure is considered technically difficult, and not as successful This Study compared the clinical outcome of lateral UKA's with medial UKA's, TKA's and a normal Population using a knee score designed to highlight the shortcomings of TKA.
Methods: 20 consecutive patients over 2 years following lateral UKA were functionally assessed. They were compared with 3 groups of 20 age and sex matched patients: those who had undergone medial UKA or TKA in the same time period, or normal controls. Clinical function was assessed at least 2 years post-operatively, using the "total knee questionaire". This consists of 55 scaled multiple choice questions. The score is derived from the product of three scales: the importance of a specific activity, the frequency with which it is undertaken, and the ease with a patient can perform it.
Results: The average patient age was 74 years. 90% of the patients reported that they were either satisfied or very satisfied with their lateral UKA, with 95% of the patients in the medial UKA group and 75 % in the TKA group reaching this level of satisfaction. The average Composite Score for the lateral UKA group was significantly better compared with the TKA group (p 0, 05).(Kneeling – (5,72/4,45), Gardening – (7,32/5,18), Pivoting – (7,83/6,78), Moving laterally – (7,76/6,91), Golfing – (9,0/5,27) and Walking with heavy bags (8,2/5,97)). The Total Composite Score was significantly better (p0, 05) in Patients after lateral UKA (7,14) compared to patients who underwent TKA (5,99). No statistically significant differences in the Total Composite Score was found between both the lateral & medial UKA patients taken as a single group compared with the control group
Conclusion: Lateral Unicompartmental Knee Arthroplasty achieves superior knee function in comparison to Total Knee Arthroplasty, so is worth considering as an option in for early OA of the lateral compartment.