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FUNCTIONAL OUTCOMES AFTER UNICOMPARTMENTAL KNEE ARTHROPLASTY



Abstract

A retrospective study of one hundred and nineteen unicompartmental knee arthroplasties was performed. Outcome measures were the Oxford twelve-item knee questionnaire, the Short Musculoskeletal Functional Assessment (SMFA) and the WOMAC. Regression analysis was performed in order to determine predictors of outcome. After an average follow up period of four years, the mean scores indicated a good to excellent functional outcome. The only predictor of outcome identified was gender, with women obtaining a better functional outcome than men. Other variables that did not influence functional outcome included age, weight, stage of disease, previous HTO and bilateral procedures.

The purpose of this study was to determine

  1. the functional outcome of unicompartmental knee arthroplasty and

  2. predictors of outcome.

Although unicompartmental knee arthroplasty is becoming more widely accepted as a treatment option for degenerative osteoarthritis, there are very few studies in the literature that systematically investigate the predictors of outcome for this procedure.

This is a retrospective study of one hundred and nineteen unicompartmental knee arthroplasties perfomed at a university hospital by a single surgeon. The outcome measures used were the Oxford twelve-item knee questionnaire, the Short Musculoskeletal Function Assessment (SMFA) and the Western Ontario and McMaster (WOMAC) functional indices. Multiple regression analysis was performed to determine predictors of outcome from chart derived variables.

After a mean follow-up of four years the mean Oxford Knee Score was thirty-nine and the mean SMFA and WOMAC functional scores were eight and seven respectively, indicating a good to excellent functional outcome. Regression analysis revealed gender as a predictor of outcome however other variables including age (range 49–84 yrs), weight (range 55–225 kgs), previous ORIF, preoperative varus/valgus (range 0–16 degrees), joint subluxation (range 0–13mm), radiographic stage of disease (Kellgren and Lawrence), as well as previous HTO and bilateral (simultaneous or staged) unicompartmental knee arthroplasty were found to not correlate with functional outcome.

Good to excellent functional outcome scores can be achieved with unicompartmental knee replacement. Previous HTO or bilateral procedures as well as weight, pre-operative varus/valgus < sixteen degrees or radiographic stage of disease were not predictive of outcome.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada