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Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study

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Abstract

Patients older than 60 with unicompartmental knee arthritis can be treated with total or unicompartmental knee replacement. The aim of this study was to compare the results of matched paired groups of patients with isolated medial compartment knee arthritis replaced with either UKR (group A) or computer-assisted TKR (group B). The results included 68 knees at a minimum follow-up of 3 years. All patients had a varus deformity no greater than 8º and a BMI lower than 30. Patients were matched in terms of preoperative arthritis severity, age, gender and preoperative range of motion. In the computer-assisted TKR group, all the implants were positioned within 4º of the correct hip-knee-ankle angle and frontal tibial component angle. The surgical time and hospital stay were statistically longer in the CA TKR group. During the study no implant required revision. The results showed higher scores for a UKR in the treatment of isolated primary unicompartmental knee arthritis in patients older than 60 compared to a computer-assisted TKR. In this study a computer-assisted alignment system for TKR with optimal implant positioning did not produce equivalent clinical results compared to a UKR, but did increase the financial costs.

Résumé

Les patients âgés de plus de 60 ans, présentant une arthrose unicompartimentale du genou ont été traités soit par une prothèse totale, soit par une prothèse unicompartimentale. Le but de cette étude est de comparer les résultats de patients présentant une arthrose fémoro tibiale interne traités par une prothèse unicompartimentale (groupe A), ou par prothèse totale du genou mise en place par chirurgie assistée par ordinateur (groupe B). Les résultats incluent 68 genoux avec un suivi minimum de 3 ans. Tous les patients avaient une déformation en varus inferiure à 8 degrés et un BMI inférieur à 30. Les patients ont été comparés en fonction du degré d’arthrose, de l’âge, du sexe et de la mobilité pré opératoire. Dans la série prothèse totale, tous les implants ont été positionnés avec une marge de 4° par rapport à l’angle hanche cheville. Le temps opératoire et la durée d’hospitalisation ont été statistiquement plus importants dans le groupe prothèse totale. Aucun implant n’a nécessité de révision. Les résultats montrent que le score est bien meilleur dans les prothèses unicompartimentales pour le traitement des arthroses unicompartimentales, chez ces patients âgés de plus de 60 ans, comparé au traitement par prothèse totale avec chirurgie assistée par ordinateur. Cette étude montre que la mise en place par chirurgie assistée par ordinateur d’une prothèse totale du genou avec un positionnement optimal des implants peut donner un résultat équivalent à celui des prothèses unicompartimentales mais augmente le coût financier du traitement.

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Authors and Affiliations

  1. Ist Orthopaedic Department, Centro Traumatologico ed Ortopedico (C.T.O.) - I.C.P., Via Bignami 1, Milan, Italy

    A. Manzotti & N. Confalonieri

  2. Orthopaedic Department, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria, Australia

    C. Pullen

  3. Via Giovanni XXIII n.24, 20060 Bettola di Pozzo d’Adda, Milan, Italy

    A. Manzotti

Authors
  1. A. Manzotti
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  2. N. Confalonieri
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  3. C. Pullen
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Correspondence to A. Manzotti.

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Manzotti, A., Confalonieri, N. & Pullen, C. Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. International Orthopaedics (SICOT) 31, 315–319 (2007). https://doi.org/10.1007/s00264-006-0184-x

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  • DOI: https://doi.org/10.1007/s00264-006-0184-x

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