Article

1 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates



@@#116300@@

Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 12 mai 2018
Doi : 10.1016/j.otsr.2018.02.015
Received : 29 December 2017 ;  accepted : 21 February 2018
Fewer complications after UKA than TKA in patients over 85 years of age: A case-control study
 

Quentin Ode a, Romain Gaillard a, Cécile Batailler a, c, Yannick Herry a, Philippe Neyret b, Elvire Servien a, Sébastien Lustig a, c,
a Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France 
b Centre Albert-Trillat, 69004 Lyon, France 
c Laboratoire de biomécanique et mécanique des chocs, université Claude-Bernard Lyon 1, IFSTTAR, 69622 Villeurbanne, France 

Corresponding author. Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France.Service de chirurgie orthopédique, CHU Lyon Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France.
Abstract
Introduction

Implanting a knee prosthesis in patients aged over 85 years is not without risk. Unicompartmental knee arthroplasty (UKA) is reputed to show lower morbidity and mortality than total knee arthroplasty (TKA). Elderly patients with isolated unicompartmental osteoarthritis without specific contraindications are thus good candidates for this procedure. The present retrospective case-control study compared complications rates in elderly patients receiving UKA versus TKA. The study hypothesis was that UKA incurs fewer complications, with equivalent functional results.

Material and methods

Five hundred and forty-four UKAs were performed between 1987 and 2015; all patients aged 85 years or over (n =30) were included, and age-matched at a rate of 1 UKA for 3 TKAs in our database of 4,216 TKA procedures. Mean age was 87.5 years (range, 85–92 years). The main endpoint was complications rate; secondary endpoints comprised satisfaction, IKS function and knee scores, and implant survival.

Results

Mean follow-up was 32 months (range, 12–118 months) for UKA and 34 months (range, 12–100 months) for TKA. The medical complications rate was significantly lower with UKA (6.7% versus 25.6%; P =0.02), with no early mortality. IKS scores were identical between UKA and TKA groups at last follow-up: knee, 93.8 (95% CI [89.7–98.0]) versus 89.5 (95% CI [85.6–93.4]), P =0.06; function, 63.8 (95% CI [53.1–74.5]) versus 67.0 (95% CI [61.3–72.7]), P =0.62. Satisfaction rates were likewise identical: 96% and 97%, respectively (P =0.77); and implant survivorship was identical (P =0.54).

Discussion

Early medical complications were fewer after UKA than TKA in a population aged 85 years, with comparable clinical outcome. These results argue in favor of UKA in elderly patients with comorbidities.

Level of evidence

III, case-control study.

The full text of this article is available in PDF format.

Keywords : Unicompartmental knee arthroplasty, Total knee arthroplasty, Geriatric surgery, Geriatrics, Complications




© 2018  Elsevier Masson SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline