Abstract
Purpose
We may consider total knee arthroplasty on one knee and unicompartmental knee arthroplasty on another knee when the patient has different grade osteoarthritis on one knee and opposite knee. Both total knee and unicompartmental knee arthroplasty had been reported as excellent clinical results, but there can be different results and different preference if the same patient undergo operation of simulataneous total knee and unicompartmental knee. We performed total and unicompartmental knee arthroplasty and pretend to report results of the clinical and radiological results and rationale of the operation.
Materials and Methods
From Marth 2007 to February 2014, 23 patients, 46 knees that underwent total knee arthroplasty and unicompartmental knee arthroplasty on knees with different osteoarthritis grade in same person enrolled in this study(Fig. 1). The mean age was 64.4 years old(range:55–75) and mean follow-up period was 25.1 months(range:13–72).
Results
The tibiofemoral angle changed from 4.0 of varus to 5.4 of valgus in the total knee arthroplasty, and from 0.5 of valgus to 3.8 of valgus in the unicompartmental knee arthroplasty. The mechanical axis deviation changed from varus 28.35mm to varus 3.68mm in the total knee arthroplasty, and from 16.42 to 8.81 in the unicompartmental knee arthroplasty. The average Hospital for Special Surgery Knee-Rating Scale(HSS) improved from 55.1 preoperatively to 93.4 at last follow-up in the total knee arthroplasty, and from 65.2 to 95.2 in the unicompartmental knee arthroplasty. The average WOMAC Score improved from 61.6 preoperatively to 18.0 at last follow-up in the total knee arthroplasty, and from 55.4 to 16.2 in the unicompartmental knee arthroplasty. For patient preference, 5 patients(22%) preferred the unicompartmental knee arthroplasty, and 6 patients(26%) preferred the total knee arthroplasty, and 12 patients felt no difference between two knees. 20 patients(87%) reported being ‘very satisfied’ or ‘satisfied’ in the total knee arthroplasty, and 18 patients(79%) reported in the unicompartmental knee arthroplasty. We underwent 1 case complication of tibial implant loosening and varus malalignment. So, we converted total knee arthroplasty about 3 months later(Fig. 2).
Conclusions
Total knee arthroplasty and unicompartmental knee arthroplasty in same person showed satisfactory clinical and radiological results. There was no difference in preference site and postoperative range of motion showed more regainment on unicompartmental knee arthroplasty. More complications were demonstrated in unicompartmental knee arthroplasty. Total and unicompartmental knee arthroplasty in same person seems to be a good option when the both knee have different osteoarthritis grade.
