Unicompartmental Knee Arthroplasty for Medial Osteoarthritis in Patients Aged 75 Years and Older: A Comparative Study Evaluating Patient Outcomes With Mobile-Bearing and Fixed-Bearing Prostheses.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42428233.
- Also identified by DOI 10.1177/21514593261467163 and PMC identifier 13346832.
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Abstract
Unicompartmental knee arthroplasty (UKA) offers potential advantages over total knee arthroplasty, but evidence regarding its efficacy in patients aged over 75 years remains limited. This comparative study evaluates clinical outcomes following UKA in patients aged ≥75 years and compares mobile-bearing (MB) versus fixed-bearing (FB) prostheses in this population. We conducted a retrospective cohort study of 189 consecutive patients aged ≥75 years who underwent UKA for medial compartment osteoarthritis (June 2021-December 2022). The cohort comprised 118 MB and 71 FB prostheses. Demographic data, perioperative complications, and patient-reported outcome measures (Knee Society Score [KSS], Oxford Knee Score [OKS], Visual Analogue Scale [VAS] for pain, and Forgotten Joint Score-12 [FJS-12]) were collected preoperatively and at minimum 12-month follow-up. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between-group comparisons, respectively. Mean follow-up was 25 months (range, 12-36 months), with no losses or deaths. Significant improvements occurred across all outcomes. Median KSS clinical score improved from 30.00 to 91.00 (P < 0.001); KSS functional from 25.00 to 70.00 (P < 0.001); OKS from 40.00 to 18.00 (P < 0.001); and VAS pain from 6.00 to 1.00 (P < 0.001). One patient (0.5%) experienced a minor cardiac event; no revisions, infections, or bearing complications occurred. No significant differences were observed between MB and FB groups for any outcome measure, including FJS-12 (median 100 both groups; P = 0.359). UKA provides significant, clinically meaningful improvements in pain and function for patients aged ≥75 years with medial compartment osteoarthritis, with low complication rates and excellent joint awareness. Both MB and FB prostheses yield equivalent outcomes. Advanced age alone should not contraindicate UKA.