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Unicompartmental knee arthroplasty in patients under the age of 60 years provides excellent clinical outcomes and 10-year implant survival: a systematic review

A study performed by the Early Osteoarthritis group of ESSKA-European Knee Associates section

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the present study was to systematically review the clinical and functional outcomes following medial unicompartmental knee arthroplasty (UKA) in patients under the age of 60 years old.

Methods

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies between 2012 and April 2022, on patients 18–60 years old who have had a unicompartmental knee replacement evaluating patient-reported outcomes measures (PROMs), were included. The Knee Society Scores (KSS) clinical score was considered the primary outcome. Pre- and post-operative range of motion (ROM), PROMs, complications and survival were recorded. Paired sample t testing was performed to compare the pre-operative with post-operative KSS.

Results

Seventeen articles comprising 2083 unicompartmental arthroplasties were included. The follow-up range was between 1 and 15 years. In eligible studies, all reported outcomes were improved following UKA. The mean KSS clinical was significantly improved from 45.5 (SD: 9.6) pre-operatively to 89.4 (SD: 4.4) post-operatively (p = 0.0001). Mean implant survival ranged 86–96.5% at 10 years follow-up. There was no significant difference between mobile and fixed bearing in terms of ROM and KSS clinical. In total, 92 revisions and 7 re-operations with implant retention were reported.

Conclusion

Unicompartmental knee arthroplasty for medial osteoarthritis is a safe, reliable and effective treatment option for patients of 60 years or younger. It provides pain relief, satisfactory activity level, excellent clinical outcomes, and up to 96.5% implant survival at 10-year follow-up.

Level of evidence

IV.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium

    Theofylaktos Kyriakidis & René Verdonk

  2. Sites South West London Elective Orthopaedic Centre, Epsom General Hospital, Dorking Road, Surrey, UK

    Vipin Asopa

  3. Department of Orthopedics, Trauma and Sports Traumatology, Catholic Clinical Centre Ruhr North, Dorsten, Germany

    Mike Baums

  4. Thessaloniki Minimally Invasive Surgery (The-MIS) Orthopaedic Center, St. Luke’s Hospital, Thessaloníki, Greece

    Trifon Totlis

  5. Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Trifon Totlis

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  1. Theofylaktos Kyriakidis
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Correspondence to Trifon Totlis.

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Kyriakidis, T., Asopa, V., Baums, M. et al. Unicompartmental knee arthroplasty in patients under the age of 60 years provides excellent clinical outcomes and 10-year implant survival: a systematic review. Knee Surg Sports Traumatol Arthrosc 31, 922–932 (2023). https://doi.org/10.1007/s00167-022-07029-9

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  • DOI: https://doi.org/10.1007/s00167-022-07029-9

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