Clinical and technical factors influencing outcomes of unicompartmental knee arthroplasty: Retrospective multicentre study of 944 knees - 26/04/13

Doi : 10.1016/j.otsr.2013.02.002

A. Sébilo ^a,^⁎ , C. Casin ^b, B. Lebel ^c, J.-L. Rouvillain ^d, S. Chapuis ^e, P. Bonnevialle ^e
the members of the Société d’Orthopédie et de Traumatologie de l’Ouest (SOO)^f
^a Département de chirurgie orthopédique, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France
^b Département de chirurgie orthopédique, CHU d’Angers, 4, rue Larrey, 49000 Angers, France
^c Clinique de la Clarence, rue Charles-Legay, 62460 Divion, France
^d Département de chirurgie orthopédique, CHU de Fort-de-France, BP 632, 97261 Fort-de-France, France
^e Institut de l’appareil locomoteur, CHU de Toulouse, unité d’orthopédie traumatologie de Purpan, place Baylac, 31052 Toulouse cedex, France
^f SOO – Société d’Orthopédie et de Traumatologie de l’Ouest, 18, rue de Bellinière, 49800 Trélazé, France

^*Corresponding author.

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Summary

Introduction

Unicompartmental knee arthroplasty (UKA) is reserved for osteoarthritis confined to a single femoro-tibial compartment with an intact anterior cruciate ligament. UKA remains controversial. The objective of this retrospective multicentre study in a large sample was to assess the influence of age, sex, body mass index (BMI), patellofemoral involvement, and implant design on functional outcomes and prosthesis survival rates.

Material and methods

Nine hundred and forty-four patients who underwent UKA at centres located in western France between 1988 and 2008 were re-evaluated. The IKS scores and KOOS were determined. Prosthesis survival according to various factors was assessed using the Kaplan-Meier method.

Results

A clinical evaluation was performed in 720 cases after a mean follow-up of 62months. The IKS function score improved by 23.6 points in men and 17.3 points in women (P=0.007). Ten-year prosthesis survival was 83.7% overall; 79% in women versus 87% in men (P<0.01); and 76.7% in patients younger than 70years versus 88.3% in those 70years or over (P<0.01). BMI had no significant influence on prosthesis survival. No significant differences between clinical outcomes or prosthesis survival were found across implant design categories.

Discussion

The retrospective design and large number of centres and surgeons mandate caution when interpreting our results. Subgroup sizes were too small for an analysis of factors such as anterior cruciate ligament deficiency, BMI>40kg/m², or cementless implant.