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No difference in return to amateur sports after medial and lateral unicompartmental knee arthroplasty in patients younger than 65 years

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to assess the return to amateur sports of patients under 65 years, following medial unicompartmental knee arthroplasty (mUKA) versus lateral unicompartmental knee arthroplasty (lUKA). It was hypothesized that patients younger than 65 years who underwent lateral or medial unicondylar knee replacement will result in similar rates to amateur sports, at a minimum follow-up of 2 years.

Method

Patients who underwent medial or lateral UKA participated in a 2-year follow-up program, where they were clinically evaluated for their return to amateur sports, using the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Furthermore, subgroup analyses by gender and age were performed. Power analysis was performed to ensure sample size considering that lUKA is implanted ten times less frequently than its medial counterpart.

Results

There were 85 patients who completed the entire minimum 2-year follow-up of which 73 belonged to the mUKA group and 12 to the lUKA group. No preoperative differences were found between the groups regarding the gender, the affected side, age, and mean follow-up. Both groups showed statistically significant improvement (p < 0.05) in their return to amateur sports in all parameters (UCLA and HAAS). No differences among the two groups were found at T0 and T1 (n.s.). All subgroups showed a statistically significant improvement (p < 0.05) with respect to the preoperative value, except for UCLA for lUKA with less than 60 years and HAAS for males in the lUKA group (n.s.). No differences were found among subgroups both at To and T1 (n.s.).

Conclusion

Both mUKA and lUKA procedures enabled all young and active patients a certain return to amateur sports 2 years after surgery, regardless of age and gender. UKA, medial or lateral, should always be considered for the treatment of isolated osteoarthritis in young and active patients with high functional demands.

Level of evidence

Cohort Study, Level of Evidence III.

Registration

Researchregistry6221 – Research Registry www.researchregistry.com.

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References

  1. Bastard C, Mirouse G, Potage D, Silbert H, Roubineau F, Hernigou P, Flouzat-Lachaniette CH (2017) Return to sports and quality of life after high tibial osteotomy in patients under 60 years of age. Orthop Traumatol Surg Res 103(8):1189–1191

    Article  CAS  Google Scholar 

  2. Burger JA, Kleeblad LJ, Sierevelt IN, Horstmann WG, Nolte PA (2019) Bearing design influences short- to mid-term survivorship, but not functional outcomes following lateral unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 27(7):2276–2288

    Article  Google Scholar 

  3. Calistri A, Di Martino L, Gurzì MD, Bove M, De Smet K, Villani C (2014) Italian version of University of California at Los Angeles (UCLA) activity score: cross-cultural adaptation. J Arthroplasty 29(9):1733–1735

    Article  Google Scholar 

  4. Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S (2018) Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg 138(12):1765–1771

    Article  CAS  Google Scholar 

  5. D’Ambrosi R, Anghilieri FM, Corona K, Mariani I, Valli F, Ursino N, Hirschmann MT (2021) Similar rates of return to sports and BMI reduction regardless of age, gender and preoperative BMI as seen in matched cohort of hypoallergenic and standard Cobalt Chromium medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-021-06467-1

    Article  PubMed  Google Scholar 

  6. Dagneaux L, Bourlez J, Degeorge B, Canovas F (2017) Return to sport after total or unicompartmental knee arthroplasty: an informative guide for residents to patients. EFORT Open Rev 2(12):496–501

    Article  Google Scholar 

  7. Garcia GH, Mahony GT, Fabricant PD, Wu HH, Dines DM, Warren RF, Craig EV, Gulotta LV (2016) Sports- and work-related outcomes after shoulder hemiarthroplasty. Am J Sports Med 44(2):490–496

    Article  Google Scholar 

  8. Hamai S, Moro-oka TA, Miura H, Shimoto T, Higaki H, Fregly BJ, Iwamoto Y, Banks SA (2009) Knee kinematics in medial osteoarthritis during in vivo weight-bearing activities. J Orthop Res 27(12):1555–1561

    Article  Google Scholar 

  9. Hamilton TW, Pandit HG, Lombardi AV, Adams JB, Oosthuizen CR, Clavé A, Dodd CA, Berend KR, Murray DW (2016) Radiological decision aid to determine suitability for medial unicompartmental knee arthroplasty: development and preliminary validation. Bone Joint J. 98B(10 Suppl B):3–10

  10. Hamilton WG, Ammeen D, Engh CA Jr, Engh GA (2010) Learning curve with minimally invasive unicompartmental knee arthroplasty. J Arthroplasty 25(5):735–740

    Article  Google Scholar 

  11. Harbourne AD, Sanchez-Santos MT, Arden NK, Filbay SR (2019) Predictors of return to desired activity 12 months following unicompartmental and total knee arthroplasty. Acta Orthop 90(1):74–80

    Article  Google Scholar 

  12. Johal S, Nakano N, Baxter M, Hujazi I, Pandit H, Khanduja V (2018) Unicompartmental knee arthroplasty: the past, current controversies, and future perspectives. J Knee Surg 31(10):992–998

    Article  Google Scholar 

  13. Kleeblad LJ, van der List JP, Zuiderbaan HA, Pearle AD (2018) Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc 26(6):1811–1822

    Article  Google Scholar 

  14. Kohn MD, Sassoon AA, Fernando ND (2016) Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res 474(8):1886–2893

    Article  Google Scholar 

  15. Liddle AD, Judge A, Pandit H, Murray DW (2014) Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales. Lancet 384(9952):1437–1445

    Article  Google Scholar 

  16. Lo Presti M, Costa GG, Cialdella S, Agrò G, Grassi A, Caravelli S, Mosca M, Marcheggiani Muccioli GM, Zaffagnini S (2019) Return to sports after unicompartmental knee arthroplasty: reality or Utopia? A 48-month follow-up prospective study. J Knee Surg 32(2):186–191

    Article  Google Scholar 

  17. Lu TW, Tsai TY, Kuo MY, Hsu HC, Chen HL (2008) In vivo three-dimensional kinematics of the normal knee during active extension under unloaded and loaded conditions using single-plane fluoroscopy. Med Eng Phys 30(8):1004–1012

    Article  CAS  Google Scholar 

  18. Matsuki K, Matsuki KO, Kenmoku T, Yamaguchi S, Sasho T, Banks SA (2017) In vivo kinematics of early-stage osteoarthritic knees during pivot and squat activities. Gait Posture 58:214–219

    Article  Google Scholar 

  19. Mohammad HR, Mellon S, Judge A, Dodd C, Murray D (2021) The effect of age on the outcomes of cementless mobile bearing unicompartmental knee replacements. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06428-0

    Article  PubMed  Google Scholar 

  20. Monticone M, Capone A, Frigau L, Marongiu G, Abelli P, Mola F, Maffulli N, Foti C (2018) Development of the Italian version of the High-Activity Arthroplasty Score (HAAS-I) following hip and knee total arthroplasty: cross-cultural adaptation, reliability, validity and sensitivity to change. J Orthop Surg Res 13(1):81

    Article  Google Scholar 

  21. Naal FD, Fischer M, Preuss A, Goldhahn J, von Knoch F, Preiss S, Munzinger U, Drobny T (2007) Return to sports and recreational activity after unicompartmental knee arthroplasty. Am J Sports Med 35(10):1688–1695

    Article  Google Scholar 

  22. Naal FD, Impellizzeri FM, Leunig M (2009) Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res 467(4):958–965

    Article  Google Scholar 

  23. Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ (2017) Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplasty 32(6):1792–1797

    Article  Google Scholar 

  24. Smith E, Lee D, Masonis J, Melvin JS (2020) Lateral unicompartmental knee arthroplasty. JBJS Rev 8(3):e0044

    Article  Google Scholar 

  25. Smith TO, Chester R, Glasgow MM, Donell ST (2012) Accelerated rehabilitation following Oxford unicompartmental knee arthroplasty: five-year results from an independent center. Eur J Orthop Surg Traumatol 22:151–158

    Article  Google Scholar 

  26. van der List JP, Chawla H, Zuiderbaan HA, Pearle AD (2016) Patients with isolated lateral osteoarthritis: unicompartmental or total knee arthroplasty? Knee 23(6):968–974

    Article  Google Scholar 

  27. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative STROBE (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)statement: guidelines for reporting observational studies. J Clin Epidemiol. 61(4):344–349

    Article  Google Scholar 

  28. Wada K, Hamada D, Takasago T, Nitta A, Goto T, Tonogai I, Tsuruo Y, Sairyo K (2018) Native rotational knee kinematics is restored after lateral UKA but not after medial UKA. Knee Surg Sports Traumatol Arthrosc 26(11):3438–3443

    Article  Google Scholar 

  29. Waldstein W, Kolbitsch P, Koller U, Boettner F, Windhager R (2017) Sport and physical activity following unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 25(3):717–728

    Article  Google Scholar 

  30. Walker T, Gotterbarm T, Bruckner T, Merle C, Streit MR (2015) Return to sports, recreational activity and patient-reported outcomes after lateral unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23(11):3281–3287

    Article  Google Scholar 

  31. Walton NP, Jahromi I, Lewis PL, Dobson PJ, Angel KR, Campbell DG (2006) Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg 19(2):112–116

    Article  Google Scholar 

  32. Wei J, Gross D, Lane NE, Lu N, Wang M, Zeng C, Yang T, Lei G, Choi HK, Zhang Y (2019) Risk factor heterogeneity for medial and lateral compartment knee osteoarthritis: analysis of two prospective cohorts. Osteoarthritis Cartilage 27(4):603–610

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. IRCCS Orthopedic Institute Galeazzi, Milan, Italy

    Riccardo D’Ambrosi, Federico Valli & Nicola Ursino

  2. Clinica Ortopedica, IRCCS Policlinico San Martino, Genova, Italy

    Chiara Ursino

  3. Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy

    Ilaria Mariani

  4. Dipartimento Di Medicina E Scienze Della Salute Vincenzo, Università Degli Studi del Molise, Campobasso, Tiberio, Italy

    Katia Corona

  5. Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Jari Dahmen

  6. Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands

    Jari Dahmen

  7. Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc, IOC Research Center, Amsterdam, The Netherlands

    Jari Dahmen

  8. Clinica Nostra Signora Della Mercede, Rome, Italy

    Fabio Valerio Sciarretta

Authors
  1. Riccardo D’Ambrosi
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  2. Chiara Ursino
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  3. Ilaria Mariani
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  4. Katia Corona
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  6. Fabio Valerio Sciarretta
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  7. Federico Valli
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  8. Nicola Ursino
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Correspondence to Riccardo D’Ambrosi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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D’Ambrosi, R., Ursino, C., Mariani, I. et al. No difference in return to amateur sports after medial and lateral unicompartmental knee arthroplasty in patients younger than 65 years. Knee Surg Sports Traumatol Arthrosc 30, 1050–1056 (2022). https://doi.org/10.1007/s00167-021-06526-7

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  • DOI: https://doi.org/10.1007/s00167-021-06526-7

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