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PATIENT SELECTION IN UNICOMPART-MENTAL KNEE JOINT REPLACEMENT



Abstract

Introduction The decision to offer a patient a knee replacement is usually based on a patient’s perception of their reduction of quality of life. The choice between unicompartmental (UCKJR) and total knee joint replacement (TKJR) is usually guided by surgeon preference. This preference has been extensively debated in the literature.

Methods The author has a series of 130 UCKJR and 370 TKJR performed over similar time spans. Oxford knee scores have been collected comparing outcomes. Radiological signs of loosening or subsidence have been recorded.

Results Short term function is superior in terms of range of motion and capacity for activities of daily living in those with UCKJR compared to TKJR. Three UCKJR and 12 TKJR have been revised. Of the three revisions of UCKJR two have been revised for pain of uncertain cause and one was loose. Three UCKJR are unsatisfactory and will come to revision. Two are showing signs of subsidence and one is painful, presumed loose without radiological signs of looseness.

Conclusions Comparing revision rates from one surgeon’s series suggests a slightly higher rate of revision with UCKJR but since prosthesis selection is made on different criteria when making the original decision to proceed, comparisons are difficult. A 95% survival figure can be given to patients about the result of this procedure. The functional outcome, earlier recovery, and shorter hospitalisation can be given as other factors to favor the procedure. The literature supports the satisfactory results of conversion of UCKJR to TKJR. A confounding argument is the frequent reporting of 98% to 100% survival of TKJR at 15 years.

The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.

None of the authors have received any payment or consideration from any source for the conduct of this study.