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General Orthopaedics

UNI OR TKR: THE 15 YEAR RESULTS OF A RANDOMISED STUDY

British Orthopaedic Association (BOA) 2007



Abstract

Between 1989 and 1992 102 knees adjudged suitable for Unicompartmental replacement (UKR) were randomised to receive either a St Georg Sled UKR or a Kinematic modular total knee replacement (TKR). The early results demonstrated that the UKR group had less complications, and more rapid rehabilitation. At 5 years there were equal failures but the UKR group had more excellent results and a greater range of movement.

Despite this doubt persisted about whether these advantages would be maintained these cases have been followed regularly by a research nurse at 8, 10, 12 years. We now report the final outcome at 15 years. 43 patients (45 knees) have died with all their knees intact. Throughout the review period the Bristol Knee Scores (BKS) of the UKR group have been better and at 15 years 77% and 53% of the surviving UKRs and TKRs achieve an excellent score. 6 TKRs and 4 UKRs have failed during the 15 years of the review.

Conclusion

The better early results with UKR are maintained at 15 years with no greater failure rate. The median BKS scores of the UKR group was 91.1 at five years and 92 at 15 years suggesting little functional deterioration in either the prosthesis or remainder of the joint. These results would seem to justify the increased use of UKR.