Abstract
Purpose:
Management of unicompartmental knee osteoarthritis (OA) in middle-aged patients is a challenging problem. Recent studies have underlined the efficacy of UKA not just in elderly, but also in middle-aged patients. The primary purpose of the present study was to determine the short to mid-term survivorship of an all-poly tibial UKA in patients under 60 years of age. The secondary purpose was to prospectively evaluate the clinical outcome in this selected group of patients.
METHODS:
Thirty-three consecutive patients under 60 years of age at the time of surgery with isolated medial compartment OA underwent a unilateral medial UKA from 2002 to 2005 and were prospectively followed. A Kaplan-Meyer analysis was performed to determine the 8-years implant survivorship with revision for any reason as endpoint. KSS, WOMAC, Tegner-Lysholm, Tegner and VAS scores were prospectively evaluated at 3 to 6 years follow-up. Weight-bearing radiographs were collected pre-operatively and at 3 to 6 years follow-up to prospectively evaluate femorotibial angle (FTA), tibial plateau angle (TPA) and posterior tibial slope (PTS).
RESULTS:
The 8-years Kaplan-Meier survivorship with revision for any reason as endpoint was 83%. Five failures were reported and in 3 patients aseptic loosening of the tibial component was the reason for failure. All clinical scores significantly improved at 3 years follow-up and no further modification was demonstrated up to 6 years follow-up, with more than 80% rated good to excellent with all the evaluation scores. FTA and PTA had a significant difference at 3-years follow-up respect to pre-operative values (p < 0.01 and p < 0.03 respectively) and no further difference at 6-years follow-up.
CONCLUSIONS:
The present data suggest that an all-poly tibial UKA is a viable option in patients under 60 years of age at the time of surgery, with isolated medial compartment OA, providing good to excellent KSS, Oxford, WOMAC, and Tegner scores in more than 80% of the patients at 3 to 6 years follow-up.
