UKA compares favorably to TKA in the same patient
By Carolyn Rogers
Unicompartmental knee arthroplasty (UKA) appears to be a valid alternative to total knee arthroplasty (TKA) for surgical management of the knee, according to poster exhibit P137. When using the same patient as a control, researchers report that UKA compared favorably with TKA. Also, when patients were asked to choose, more preferred the UKA to the TKA.
Surgical options for medial compartment disease of the knee include TKA and UKA, but patients and surgeons often have difficulty deciding on which procedure to undertake, given the same radiographic and clinical symptoms. To determine whether one procedure is superior to the other, the investigators reviewed the experiences of patients who have a TKA on one side and a UKA on the opposite side.
After reviewing their database, researchers identified 24 patients with osteoarthritis who met the above criteria. Preoperative radiographs were reviewed to confirm that the TKA patients had medial compartment disease only. The Knee Society score (KSS), radiographic analysis, and patient preferences were recorded for all patients.
TKA knees had an average KSS of 51 preoperatively and 94 at the most recent follow-up. UKA knees had an average KSS of 46 preoperatively and 95 at follow-up. Average follow-up was three years.
Knee range of motion averaged 0° to 125° in the UKA group, and 0° to 123° in the TKA group. No implants were loose and there were no progressive radiolucencies.
When asked to choose which procedure they preferred, 50 percent of patients said they preferred their UKA. None of the patients preferred their TKA.
The lead researcher is David F. Dalury, MD, of Baltimore with David A Fisher, MD, of Indianapolis; Ricardo Gonzales, MD, of Hopkinton, N.H.; Mary Jo Adams, BSN, of Pylesville, Md.; and Melanie R Watts, ATC-L, of Indianapolis. Research support was provided by DePuy.