The role of high tibial osteotomy (HTO) is being questioned by
the use of unicompartmental knee arthroplasty (UKA) in the treatment
of medial compartment femorotibial osteoarthritis. Our aim was to
compare the outcomes of revision HTO or UKA to a total knee arthroplasty
(TKA) using computer-assisted surgery in matched groups of patients. We conducted a retrospective study to compare the clinical and
radiological outcome of patients who underwent revision of a HTO
to a TKA (group 1) with those who underwent revision of a medial
UKA to a TKA (group 2). All revision procedures were performed using
computer-assisted surgery. We extracted these groups of patients
from our database. They were matched by age, gender, body mass index,
follow-up and pre-operative functional score. The outcomes included
the Knee Society Scores (KSS), radiological outcomes and the rate
of further revision.Aims
Patients and Methods
The significance of weight in the indications
for unicompartmental knee replacement (UKR) is unclear. Our hypothesis was
that weight does not affect the long-term rate of survival of UKRs. We undertook a retrospective study of 212 UKRs at a mean follow-up
of 12 years (7 to 22). The patients were distributed according to
body mass index (BMI; <
The ten-year rates of survival were similar in the two weight
subgroups (≥ 82 kg: 93.5% (95% confidence interval (CI) 66.5 to
96.3); <
82 kg: 92.5% (95% CI 82.5 to 94.1)) and also in the
two BMI subgroups (≥ 30 kg/m2: 92% (95% CI 82.5 to 95.3);
<
30 kg/m2: 94% (95% CI 78.4 to 95.9)). Multimodal
regression analysis revealed that weight plays a part in reducing
the risk of revision with a relative risk of 0.387, although this
did not reach statistical significance (p = 0.662). The results
relating weight and BMI to the clinical outcome were not statistically
significant. Thus, this study confirms that weight does not influence
the long-term rate of survival of UKR. Cite this article:
