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A novel preoperative scoring system for the indication of unicompartmental knee arthroplasty, as predictor of clinical outcome and satisfaction

  • Alexander Antoniadis
  • Dimitris Dimitriou
  • Jean Pierre Canciani
  • Naeder Helmy
Knee Arthroplasty
  • 30 Downloads

Abstract

Introduction

Proper patient selection is a crucial factor for the outcome of the unicompartmental knee arthroplasty (UKA). However, there is still not a clear consensus on which patients could benefit the utmost from a UKA. The purpose of this prospective study was to introduce a novel, preoperative, predictive score (Unicompartmental Indication Score, UIS) to aid proper patient selection in UKA.

Materials and methods

A total of 152 patients with an average age of 68 years and a mean follow-up of 27 months were evaluated preoperatively with the UIS and postoperative at every follow-up. Correlation analysis was applied to identify potential relationships between the UIS, functional outcomes, pain relief, patient satisfaction, and range of motion. The ROC analysis was used to identify the best cutoff value of the UIS, which would have predicted an optimal outcome following UKA.

Results

The majority of the patients (91%) were satisfied with the operation, with 61% reporting excellent and 30% good satisfaction. The UIS was positively correlated to the postoperative Knee Society Score (KSS) for both pain (r = 0.26, p < 0.001) and function (r = 0.31, p < 0.001). The UIS was also positively correlated to the patient satisfaction (p = 0.46, p < 0.001) and maximum postoperative flexion (r = 0.25, p < 0.001). The ROC analysis provided an ideal cutoff for UIS at 25 points (sensitivity: 75%, sensibility: 93%, area under the curve: 86%). At a mean follow-up of 27 months (range 24–37), we observed three revisions in 152 consecutive UKA with a mean UIS of 27 points (range 20–30).

Conclusions

The newly introduced UIS score might be a reliable preoperative scoring system to predict patients with excellent satisfaction, functional outcome, pain relief and possibly implant survivorship following UKA, and therefore, could help the proper patient selection and decision-making in UKA.

Level-of-evidence

Prospective study, II.

Keywords

Unicompartmental knee arthroplasty (UKA) Indication Clinical Outcome Patient-reported outcomes Predictive score Patient satisfaction Revision Scoring system 

Notes

Funding

There was no external funding source of funding in the current study.

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedics and TraumatologyBürgerspital SolothurnSolothurnSwitzerland
  2. 2.Centre Hospitalier Prive Saint GregoireSaint-GrégoireFrance

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