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No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Medial unicompartmental knee arthroplasty (UKA) has excellent survival rates using one of the two implant designs: mobile bearing (MB) or fixed bearing (FB). There is a lack of studies comparing patient-reported outcomes (PROs) of both implants. This study aimed to document and compare PROs of MB UKA to FB UKA at 6, 12 and 24 months after surgery.

Methods

A single high-volume surgeon, retrospective cohort study with prospectively collected data of two groups of UKA patients, with a MB (n = 66) or FB (n = 97) implant. Primary outcome was patient satisfaction (0–10; NRS). Secondary outcomes were pain at rest (NRS), pain during activity (NRS), function (OKS, KOOS-PS), quality of life (EQ-5D-3L), anchor pain, anchor function and anchor recovery. PROs were collected 6, 12 and 24 months postoperatively. The complication rate and revision rate within one year after surgery were recorded.

Results

For the MB group, the median NRS satisfaction score was 9.0 (8.0–10.0) compared to 9.0 (8.0–9.5) for the FB group at 6 months (p = 0.620). Similar scores were found at 12 and 24 months; both MB 9.0 (8.0–10.0) and FB 9.0 (8.0–10.0) (p = 0.556 and p = 0.522, respectively). There were no statistically significant differences between MB and FB groups in all secondary outcomes postoperatively.

Conclusion

Medial UKA performed by a high-volume surgeon, using a MB or a FB implant, results in excellent patient satisfaction, pain relief, functional improvement and quality of life improvement at 6, 12 and 24 months after surgery. The recommendation and use of one over the other is not justified based on the outcomes in the current study.

Level of evidence

III.

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Abbreviations

ASA:

American Society of Anaesthesiologists score

BMI:

Body mass index

EQ VAS:

EuroQol Visual Analogue Scale

EQ-5D-3L:

EuroQol 5 dimensions 3-level version

FB:

Fixed bearing implant

GPR:

General Perceived Recovery

ICHOM:

International Consortium for Health Outcomes Measurement

IQR:

Interquartile range

ISAR:

International Society of Arthroplasty Registries

KA:

Knee arthroplasty

Kg/m2 :

Kilogramme per square metre

KOOS-PS:

Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form

L:

Left

LROI:

Dutch National Registry Orthopaedic Implants

MB:

Mobile bearing implant

n :

Number

NJR:

English National Joint Registry

NOV:

Dutch Orthopaedic Association

NRS:

Numeric Rating Scale

OA:

Osteoarthritis

OKS:

Oxford Knee Score

PROMs:

Patient-reported outcome measures

PROs:

Patient-reported outcomes

SD:

Standard deviation

UKA:

Unicompartmental knee arthroplasty

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Acknowledgements

We would like to thank Klaartje van Diepen—Pijnappels and Maud Peters for their consistent data collection and kindness help to all patients in case of questions, and all patients for completing their PROMs.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Research Department, Kliniek ViaSana, Hoogveldseweg 1, 5451 AA, Mill, The Netherlands

    Yvette Pronk & Angela Anna Maria Paters

  2. Department of Orthopaedic Surgery, Kliniek ViaSana, Hoogveldseweg 1, 5451 AA, Mill, The Netherlands

    Justus-Martijn Brinkman

Authors
  1. Yvette Pronk
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  2. Angela Anna Maria Paters
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Contributions

YP designed the study, supervised the performed data analysis and interpretation of data, and drafted the manuscript. AP performed the data analysis and interpretation of data supervised by YP, and revised the manuscript. JMB performed interpretation of data and revised the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Yvette Pronk.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This is a retrospective study on the already collected data and all patients signed the informed consent to allow further scientific analysis using their anonymised data, and thus, the institutional review board deemed that formal approval was not required for this study.

Informed consent

All patients signed informed consent to allow further scientific analysis using their anonymised data.

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Pronk, Y., Paters, A.A.M. & Brinkman, JM. No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 29, 947–954 (2021). https://doi.org/10.1007/s00167-020-06053-x

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  • DOI: https://doi.org/10.1007/s00167-020-06053-x

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