Quentin Ode1, Romain Gaillard1, Cécile Batailler2, Yannick Herry1, Philippe Neyret3, Elvire Servien1, Sébastien Lustig4. 1. Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France. 2. Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Laboratoire de biomécanique et mécanique des chocs, université Claude-Bernard Lyon 1, IFSTTAR, 69622 Villeurbanne, France. 3. Centre Albert-Trillat, 69004 Lyon, France. 4. Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; Laboratoire de biomécanique et mécanique des chocs, université Claude-Bernard Lyon 1, IFSTTAR, 69622 Villeurbanne, France. Electronic address: sebastien.lustig@gmail.com.
Abstract
INTRODUCTION: Implanting a knee prosthesis in patients aged over 85 years is not without risk. Unicompartmental knee arthroplasty (UKA) is reputed to show lower morbidity and mortality than total knee arthroplasty (TKA). Elderly patients with isolated unicompartmental osteoarthritis without specific contraindications are thus good candidates for this procedure. The present retrospective case-control study compared complications rates in elderly patients receiving UKA versus TKA. The study hypothesis was that UKA incurs fewer complications, with equivalent functional results. MATERIAL AND METHODS: Five hundred and forty-four UKAs were performed between 1987 and 2015; all patients aged 85 years or over (n=30) were included, and age-matched at a rate of 1 UKA for 3 TKAs in our database of 4,216 TKA procedures. Mean age was 87.5 years (range, 85-92 years). The main endpoint was complications rate; secondary endpoints comprised satisfaction, IKS function and knee scores, and implant survival. RESULTS: Mean follow-up was 32 months (range, 12-118 months) for UKA and 34 months (range, 12-100 months) for TKA. The medical complications rate was significantly lower with UKA (6.7% versus 25.6%; P=0.02), with no early mortality. IKS scores were identical between UKA and TKA groups at last follow-up: knee, 93.8 (95% CI [89.7-98.0]) versus 89.5 (95% CI [85.6-93.4]), P=0.06; function, 63.8 (95% CI [53.1-74.5]) versus 67.0 (95% CI [61.3-72.7]), P=0.62. Satisfaction rates were likewise identical: 96% and 97%, respectively (P=0.77); and implant survivorship was identical (P=0.54). DISCUSSION: Early medical complications were fewer after UKA than TKA in a population aged ≥85 years, with comparable clinical outcome. These results argue in favor of UKA in elderly patients with comorbidities. LEVEL OF EVIDENCE: III, case-control study.
INTRODUCTION: Implanting a knee prosthesis in patients aged over 85 years is not without risk. Unicompartmental knee arthroplasty (UKA) is reputed to show lower morbidity and mortality than total knee arthroplasty (TKA). Elderly patients with isolated unicompartmental osteoarthritis without specific contraindications are thus good candidates for this procedure. The present retrospective case-control study compared complications rates in elderly patients receiving UKA versus TKA. The study hypothesis was that UKA incurs fewer complications, with equivalent functional results. MATERIAL AND METHODS: Five hundred and forty-four UKAs were performed between 1987 and 2015; all patients aged 85 years or over (n=30) were included, and age-matched at a rate of 1 UKA for 3 TKAs in our database of 4,216 TKA procedures. Mean age was 87.5 years (range, 85-92 years). The main endpoint was complications rate; secondary endpoints comprised satisfaction, IKS function and knee scores, and implant survival. RESULTS: Mean follow-up was 32 months (range, 12-118 months) for UKA and 34 months (range, 12-100 months) for TKA. The medical complications rate was significantly lower with UKA (6.7% versus 25.6%; P=0.02), with no early mortality. IKS scores were identical between UKA and TKA groups at last follow-up: knee, 93.8 (95% CI [89.7-98.0]) versus 89.5 (95% CI [85.6-93.4]), P=0.06; function, 63.8 (95% CI [53.1-74.5]) versus 67.0 (95% CI [61.3-72.7]), P=0.62. Satisfaction rates were likewise identical: 96% and 97%, respectively (P=0.77); and implant survivorship was identical (P=0.54). DISCUSSION: Early medical complications were fewer after UKA than TKA in a population aged ≥85 years, with comparable clinical outcome. These results argue in favor of UKA in elderly patients with comorbidities. LEVEL OF EVIDENCE: III, case-control study.
Authors: David H Dejour; Jacobus H Müller; Mo Saffarini; Michel Timoteo; Pierre Chambat; Gerard Deschamps; Michel P Bonnin Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-03-04 Impact factor: 4.342
Authors: Juan C Suarez; Anshul Saxena; William Arguelles; John M Watson Perez; Venkataraghavan Ramamoorthy; Yvette Hernandez; Chukwuemeka U Osondu Journal: Arthroplast Today Date: 2022-08-29
Authors: Filippo Migliorini; Arne Driessen; Francesco Oliva; Gayle D Maffulli; Markus Tingart; Nicola Maffulli Journal: J Orthop Surg Res Date: 2020-11-19 Impact factor: 2.359