Unicompartmental Knee Arthroplasties are Performed on the Patients with Radiologically Too Mild Osteoarthritis

Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates. Aims: This study aimed...

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Bibliographic Details
Published in:	Scandinavian journal of surgery Vol. 106; no. 4; pp. 338 - 341
Main Authors:	Knifsund, J., Hatakka, J., Keemu, H., Mäkelä, K., Koivisto, M., Niinimäki, T.
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-12-2017
Subjects:	Adult Aged Aged, 80 and over Arthroplasty, Replacement, Knee Clinical Decision-Making - methods Female Follow-Up Studies Humans Male Middle Aged Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - surgery Patient Selection Radiography Reoperation - statistics & numerical data Retrospective Studies Severity of Illness Index Treatment Outcome knee arthroplasty Oxford unicondylar arthroplasty mild osteoarthritis revision rate Oxford unicompartmental knee replacement unicompartmental knee arthroplasty knee unicompartmental arthroplasty
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Summary:	Background: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates. Aims: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty. Methods: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty. The mean age at the time of operation was 67 years, and the mean follow-up time was 8.7 years. Results and Conclusion: The knees with a preoperative Kellgren–Lawrence grade of 0–2 osteoarthritis had a higher risk of reoperation than those with a Kellgren–Lawrence grade of 3–4 (odds ratio = 1.89; 95% confidence interval, 1.03–3.45; p = 0.04). In addition, the knees with a medial joint space width of more than 1 mm or a high medial/lateral joint space width ratio had an increased risk of reoperation. In conclusion, we suggest that unicompartmental knee arthroplasty should only be performed in cases showing severe osteoarthritis in preoperative radiographs, with medial bone-on-bone contact, and a medial/lateral ratio of <20%.
ISSN:	1457-4969 1799-7267
DOI:	10.1177/1457496917701668