The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study
- 186 Downloads
The purpose of this study was to assess whether unicompartmental knee arthroplasty (UKA) results in better patient-reported and clinical outcome than total knee arthroplasty (TKA). The study hypothesis was UKA yields better patient-reported and clinical outcomes than TKA.
Our prospective cohort study compared patients who underwent medial UKA or TKA from February 2014 through June 2015. Forgotten Joint Score (FJS), the short form of the Knee Injury and Osteoarthritis Outcome Score (KOOS PS), EuroQOL Five Dimensions Questionnaire (EQ-5D), and the Knee Society Score (KSS) were completed at two weeks, six weeks, three months, six months, and one year post-operatively. The KOOS PS, EQ-5D, and the KSS were also documented pre-operatively.
Fifty-seven patients (57 knees) were allocated to the UKA group and 62 patients (62 knees) to the TKA group. At baseline, no statistically significant differences were observed between groups regarding patient demographics and pre-operative scores. Except for FJS at 2 weeks (p = 0.326), all postoperative scores revealed significant differences as early as two weeks and up to 12 months (p < 0.05).
Our findings suggest UKA patients are less aware of their joint replacements than TKA patients for medial osteoarthritis of the knee. UKA conserves more soft tissue and bone than TKA, which may be the reason for the differences observed.
KeywordsCohort study Forgotten joint score Osteoarthritis Knee Patient-reported outcome Total knee arthroplasty Unicompartmental knee arthroplasty
Compliance with ethical standards
Conflict of interest
GP is a Consultant for Zimmer Biomet. The other authors have no conflicts of interest.
- 3.Rajasekaran RB, Palanisami DR, Natesan R, Rajasekaran S (2018) Minimal under-correction gives better outcomes following total knee arthroplasty in severe varus knees-myth or reality?-analysis of one hundred sixty two knees with varus greater than fifteen degrees. Int OrthopGoogle Scholar
- 4.Affatato S, Caputo D, Bordini B (2018) Does the body mass index influence the long-term survival of unicompartmental knee prostheses? A retrospective multi-centre study. Int OrthopGoogle Scholar
- 5.Cho KJ, Seon JK, Jang WY, Park CG, Song EK (2018) Robotic versus conventional primary total knee arthroplasty: clinical and radiological long-term results with a minimum follow-up of ten years. Int OrthopGoogle Scholar
- 9.Liebensteiner M, Wurm A, Gamper D, Oberaigner W, Dammerer D, Krismer M (2018) Patient satisfaction after total knee arthroplasty is better in patients with pre-operative complete joint space collapse. Int OrthopGoogle Scholar
- 12.Chatellard R, Sauleau V, Colmar M, Robert H, Raynaud G, Brilhault J, Societe d’ Orthopedie et de Traumatologie de lO (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99 (4 Suppl):S219–S225Google Scholar
- 13.Lee JK, Kim HJ, Park JO, Yang JH (2018) Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis. Knee Surg Sports Traumatol ArthroscGoogle Scholar
- 14.Cho WJ, Kim JM, Kim WK, Kim DE, Kim NK, Bin SI (2018) Mobile-bearing unicompartmental knee arthroplasty in old-aged patients demonstrates superior short-term clinical outcomes to open-wedge high tibial osteotomy in middle-aged patients with advanced isolated medial osteoarthritis. Int OrthopGoogle Scholar
- 17.Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V (2008) Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop 79(4):499–507CrossRefGoogle Scholar
- 24.Sugita T, Miyatake N, Aizawa T, Sasaki A, Kamimura M, Takahashi A (2018) Quality of life after staged bilateral total knee arthroplasty: a minimum five-year follow-up study of seventy-eight patients. Int OrthopGoogle Scholar
- 26.Kim MK, Yoon JR, Yang SH, Shin YS (2018) Unicompartmental knee arthroplasty fails to completely restore normal gait patterns during level walking. Knee Surg Sports Traumatol ArthroscGoogle Scholar
- 27.Kleeblad LJ, van der List JP, Zuiderbaan HA, Pearle AD (2018) Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc 26(6):1811–1822CrossRefGoogle Scholar
- 28.Burn E, Sanchez-Santos MT, Pandit HG, Hamilton TW, Liddle AD, Murray DW, Pinedo-Villanueva R (2018) Ten-year patient-reported outcomes following total and minimally invasive unicompartmental knee arthroplasty: a propensity score-matched cohort analysis. Knee Surg Sports Traumatol Arthrosc 26(5):1455–1464CrossRefGoogle Scholar
- 37.Davis AM, Perruccio AV, Canizares M, Hawker GA, Roos EM, Maillefert JF, Lohmander LS (2009) Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for osteoarthritis. Osteoarthr Cartil 17(7):843–847CrossRefGoogle Scholar
- 39.Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248(11):13–14Google Scholar
- 42.Verbeke G, Molenberghs G (2000) Linear mixed models for longitudinal data, Springer Series in Statistics. Springer, New YorkGoogle Scholar
- 46.Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ (2017) Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplast 32(6):1792–1797CrossRefGoogle Scholar
- 48.Hamilton TW, Rizkalla J, Kontochristos L, Marks B, Mellon S, Dodd CAF, Pandit HG, Murray DW (2017) The interaction of caseload and usage in determining outcomes of unicompartmental knee arthroplasty: a meta-analysis. J ArthroplastGoogle Scholar