2017 ISAKOS Biennial Congress ePoster #1256

 

Comparison Of 5-Year Outcome In A Continuous Series Of Uka And Tka Performed By The Same Surgeon

Michel Bercovy, MD, Paris FRANCE
CLINIQUE ARAGO, PARIS, FRANCE

The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: zimmerBiomet, ROCC VANGUARD TKA; zimmer biomet, alpina UKA

Summary

UKA HAD IDENTICAL FUNCTIONAL RESULTS BUT HIGHER RATE OF REVISION SURGERY THAN TKA

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Abstract

The objective of the present retrospective study was to compare medium-term results between uni- and tri-compartmental knee arthroplasty (UKA and TKA, respectively) implanted by a single surgeon during the same time-period.

Material And Methods

Between September 2008 and December 2009, 64 UKAs and 207 TKAs were implanted by the same surgeon.

Results

were assessed at a minimum 5 years' follow-up on the IKS, Forgotten Knee and UCLA activity scores; revision rates were compared.
Indications for UKA were single-compartment Ahlbach grade 4 osteoarthritis in stable knee without patellofemoral involvement, and for TKA Ahlbach grade 4 of at least 1 compartment associated with either irreducible mechanical axis deformity greater than 5° or patellofemoral involvement.
The 2 groups were comparable for age (UKA 68 years (46-85); TKA, 69.5 years (48-89)), gender (F/M ratio, 63/37% and 65.2/34.8%, respectively), BMI ( 29 (20-45) and 30 (20-47)) and follow-up (5.7 and 5.9 years).
Surgery time was 46 min (35-65) for UKAs and 65 min (50-155) for TKAs.
(p<0.03)
There was, however, a significant difference in preoperative severity: mean Knee Society Knee Score (KSKS) 47.6 (0-76) versus 38.8 (5-61) (p<0.05) and Knee Society Function Score (KSFS) 53 (27-100) versus 37 (0-90) in UKA and TKA, respectively (p<0.05).

Results

4 knees underwent revision in the UKA group: 2 for tibial loosening and 2 for lateral and patellofemoral compartment deterioration unrelated to overcorrection of the mechanical axis.
In the TKA group, 1 knee was revised for immediate fixation failure in a cementless femoral component (odds ratio, 0.73; p<0.003).
Mean flexion range was 133° (100°-150°) in the UKA group and 127° (95°-155°) in the TKA group (p<0.05).
Mean KSKS was 95 (45-100) in the UKA group and 94 (35-100) in the TKA group (n.s.), and KSFS 97 (0-100) and 92 (0-100), respectively. There were 37.5% totally Forgotten Knees in the UKA group and 44.8% in the TKA group (ns). UCLA activity score was 7.06/10 (4-9) and 7.10 (1-10), respectively (ns).
Discussion/Conclusion
The present study compared results on UKA and TKA performed by a single surgeon equally experienced in both. Although arthritic deterioration was higher with TKA, the UKA group showed a significantly higher rate of revision surgery for clinically equivalent results, including sport; only flexion was slightly better in the UKA group.
In the light of these results, we would reserve indications for UKA to elderly subjects, as operative time is shorter and recovery of flexion easier.

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