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Functional scores and prosthetic implant placement are different for navigated medial UKA left in varus alignment

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to analyze the clinical outcomes and radiologic position of the knee in two groups of patients after medial unicompartmental knee arthroplasty (UKA): one group with residual varus axis (RVA) alignment and other one with neutral mechanical axis (NMA) of the lower limb.

Methods

All patients who underwent UKA between January 2015 and January 2018 were evaluated retrospectively. Inclusion criteria were: medial UKA for isolated medial femoro-tibial osteoarthritis, a varus deformity of < 15°, and a minimal follow-up of 2 years. All patients had a preoperative and postoperative clinical examination with functional scores (New International Knee Score (NewIKS) and Knee injury and Osteoarthritis Outcome Score (KOOS) and radiographs. Preoperative and postoperative values for continuous outcomes were compared using the Student’s t test for paired data and differences between the groups were compared with the Mann–Whitney U test. p < 0.05 was considered statistically significant.

Results

The RVA group consisted of 48 cases of medial UKA in 48 patients (22 females). Mean postoperative hip–knee–ankle (HKA) angle was 174.3° ± 2.8 and the corresponding mean AKI angle (tibial mechanical angle) was 82.9° ± 2.9. The NMA group consisted of 35 cases of medial UKA in 35 patients (14 females). Mean postoperative HKA angle was 178.9° ± 3 and the corresponding mean AKI angle was 85.5° ± 3.1. A significant difference was found between the two groups for the KOOS score and for global NewIKS, with a better score in the RVA group.

Conclusions

RVA alignment after medial UKA results in a significant improvement in functional knee scores at 2-year post-surgery. Return to sport and recreational activities was better than in patients with postoperative NMA.

Level of evidence

Level 3; retrospective cohort study.

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Data availability

Raw data for dataset are not publicly available to preserve individuals’ privacy under the European General Data Protection Regulation.

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Funding

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

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Authors and Affiliations

  1. IULS, CHU Nice, Nice, France

    Adil Douiri

  2. Sport Clinique of, Bordeaux-Mérignac, France

    Adil Douiri, Nicolas Bouguennec, Alexandre Biset, Philippe Colombet, Pierre Laboudie & Nicolas Graveleau

  3. Assistance Publique Hôpitaux de Paris (APHP), Paris, France

    Alexandre Biset & Pierre Laboudie

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  1. Adil Douiri
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  2. Nicolas Bouguennec
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Contributions

(1) The conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted, (4) Statistics: AD: 1–2–3–4; NB: 2–3; AB: 2–3; PC: 2–3; PL: 2–3–4; NG: 1–2–3. All authors read and approved the final manuscript.

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Correspondence to Adil Douiri.

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All authors declare that they have no competing interests.

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This study was accepted by our institutional ethical committee.

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Douiri, A., Bouguennec, N., Biset, A. et al. Functional scores and prosthetic implant placement are different for navigated medial UKA left in varus alignment. Knee Surg Sports Traumatol Arthrosc 31, 3919–3926 (2023). https://doi.org/10.1007/s00167-023-07388-x

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  • DOI: https://doi.org/10.1007/s00167-023-07388-x

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