Tags

Type your tag names separated by a space and hit enter

Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction vs Total Knee Arthroplasty in Patients Younger Than 55 Years. A Propensity Score-Matched Cohort Analysis.
J Arthroplasty. 2018 02; 33(2):355-361.JA

Abstract

BACKGROUND

Improvements in surgical techniques, implant design, and adherence to indications have resulted in favorable outcomes after unicompartmental knee arthroplasty (UKA), particularly in an older population. However, no studies have compared the performance of contemporary UKA and total knee arthroplasty (TKA) in a young population.

METHODS

Prospectively collected registry data of 160 UKAs performed in 160 patients younger than 55 years were reviewed. Propensity scores generated using logistic regression were used to adjust for confounding variables of age, gender, body mass index, preoperative range of motion, Knee Society Score, Oxford Knee Score, and Short-Form 36, allowing matching of the TKA cohort to the UKA cohort in a 1:1 ratio using the nearest-neighbor method.

RESULTS

The UKA group had significantly greater flexion at 6 months and 2 years (P < .001). There was no significant difference in Knee Society Score, Oxford Knee Score, and Short-Form 36. At 2 years, 89.4% and 88.8% of the TKA and UKA groups were satisfied (P = 1.00) while 86.9% and 86.3% had their expectations fulfilled (P = 1.00). At a mean follow-up of 7 years, there were 2 revisions in each group (2.2%).

CONCLUSION

Although native knee biomechanics are preserved, younger patients do not seem to perceive this oft-cited benefit of UKA, as this did not translate into greater health-related quality of life or patient satisfaction compared to TKA. The theoretical advantages of UKA were not borne out by our findings, other than greater flexion up to 2 years postoperatively.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28993076

Citation

Goh, Graham Seow-Hng, et al. "Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction Vs Total Knee Arthroplasty in Patients Younger Than 55 Years. a Propensity Score-Matched Cohort Analysis." The Journal of Arthroplasty, vol. 33, no. 2, 2018, pp. 355-361.
Goh GS, Bin Abd Razak HR, Tay DK, et al. Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction vs Total Knee Arthroplasty in Patients Younger Than 55 Years. A Propensity Score-Matched Cohort Analysis. J Arthroplasty. 2018;33(2):355-361.
Goh, G. S., Bin Abd Razak, H. R., Tay, D. K., Chia, S. L., Lo, N. N., & Yeo, S. J. (2018). Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction vs Total Knee Arthroplasty in Patients Younger Than 55 Years. A Propensity Score-Matched Cohort Analysis. The Journal of Arthroplasty, 33(2), 355-361. https://doi.org/10.1016/j.arth.2017.09.022
Goh GS, et al. Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction Vs Total Knee Arthroplasty in Patients Younger Than 55 Years. a Propensity Score-Matched Cohort Analysis. J Arthroplasty. 2018;33(2):355-361. PubMed PMID: 28993076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unicompartmental Knee Arthroplasty Achieves Greater Flexion With No Difference in Functional Outcome, Quality of Life, and Satisfaction vs Total Knee Arthroplasty in Patients Younger Than 55 Years. A Propensity Score-Matched Cohort Analysis. AU - Goh,Graham Seow-Hng, AU - Bin Abd Razak,Hamid Rahmatullah, AU - Tay,Darren Keng-Jin, AU - Chia,Shi-Lu, AU - Lo,Ngai-Nung, AU - Yeo,Seng-Jin, Y1 - 2017/09/19/ PY - 2017/05/03/received PY - 2017/08/02/revised PY - 2017/09/02/accepted PY - 2017/10/11/pubmed PY - 2019/1/22/medline PY - 2017/10/11/entrez KW - age 55 KW - outcomes KW - satisfaction KW - total knee arthroplasty KW - unicompartmental knee arthroplasty KW - young SP - 355 EP - 361 JF - The Journal of arthroplasty JO - J Arthroplasty VL - 33 IS - 2 N2 - BACKGROUND: Improvements in surgical techniques, implant design, and adherence to indications have resulted in favorable outcomes after unicompartmental knee arthroplasty (UKA), particularly in an older population. However, no studies have compared the performance of contemporary UKA and total knee arthroplasty (TKA) in a young population. METHODS: Prospectively collected registry data of 160 UKAs performed in 160 patients younger than 55 years were reviewed. Propensity scores generated using logistic regression were used to adjust for confounding variables of age, gender, body mass index, preoperative range of motion, Knee Society Score, Oxford Knee Score, and Short-Form 36, allowing matching of the TKA cohort to the UKA cohort in a 1:1 ratio using the nearest-neighbor method. RESULTS: The UKA group had significantly greater flexion at 6 months and 2 years (P < .001). There was no significant difference in Knee Society Score, Oxford Knee Score, and Short-Form 36. At 2 years, 89.4% and 88.8% of the TKA and UKA groups were satisfied (P = 1.00) while 86.9% and 86.3% had their expectations fulfilled (P = 1.00). At a mean follow-up of 7 years, there were 2 revisions in each group (2.2%). CONCLUSION: Although native knee biomechanics are preserved, younger patients do not seem to perceive this oft-cited benefit of UKA, as this did not translate into greater health-related quality of life or patient satisfaction compared to TKA. The theoretical advantages of UKA were not borne out by our findings, other than greater flexion up to 2 years postoperatively. SN - 1532-8406 UR - https://www.unboundmedicine.com/medline/citation/28993076/Unicompartmental_Knee_Arthroplasty_Achieves_Greater_Flexion_With_No_Difference_in_Functional_Outcome_Quality_of_Life_and_Satisfaction_vs_Total_Knee_Arthroplasty_in_Patients_Younger_Than_55_Years__A_Propensity_Score_Matched_Cohort_Analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-5403(17)30807-0 DB - PRIME DP - Unbound Medicine ER -