Abstract
Purpose
Medial unicompartmental knee arthroplasty (UKA) has excellent survival rates using one of the two implant designs: mobile bearing (MB) or fixed bearing (FB). There is a lack of studies comparing patient-reported outcomes (PROs) of both implants. This study aimed to document and compare PROs of MB UKA to FB UKA at 6, 12 and 24 months after surgery.
Methods
A single high-volume surgeon, retrospective cohort study with prospectively collected data of two groups of UKA patients, with a MB (n = 66) or FB (n = 97) implant. Primary outcome was patient satisfaction (0–10; NRS). Secondary outcomes were pain at rest (NRS), pain during activity (NRS), function (OKS, KOOS-PS), quality of life (EQ-5D-3L), anchor pain, anchor function and anchor recovery. PROs were collected 6, 12 and 24 months postoperatively. The complication rate and revision rate within one year after surgery were recorded.
Results
For the MB group, the median NRS satisfaction score was 9.0 (8.0–10.0) compared to 9.0 (8.0–9.5) for the FB group at 6 months (p = 0.620). Similar scores were found at 12 and 24 months; both MB 9.0 (8.0–10.0) and FB 9.0 (8.0–10.0) (p = 0.556 and p = 0.522, respectively). There were no statistically significant differences between MB and FB groups in all secondary outcomes postoperatively.
Conclusion
Medial UKA performed by a high-volume surgeon, using a MB or a FB implant, results in excellent patient satisfaction, pain relief, functional improvement and quality of life improvement at 6, 12 and 24 months after surgery. The recommendation and use of one over the other is not justified based on the outcomes in the current study.
Level of evidence
III.
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Abbreviations
- ASA:
-
American Society of Anaesthesiologists score
- BMI:
-
Body mass index
- EQ VAS:
-
EuroQol Visual Analogue Scale
- EQ-5D-3L:
-
EuroQol 5 dimensions 3-level version
- FB:
-
Fixed bearing implant
- GPR:
-
General Perceived Recovery
- ICHOM:
-
International Consortium for Health Outcomes Measurement
- IQR:
-
Interquartile range
- ISAR:
-
International Society of Arthroplasty Registries
- KA:
-
Knee arthroplasty
- Kg/m2 :
-
Kilogramme per square metre
- KOOS-PS:
-
Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form
- L:
-
Left
- LROI:
-
Dutch National Registry Orthopaedic Implants
- MB:
-
Mobile bearing implant
- n :
-
Number
- NJR:
-
English National Joint Registry
- NOV:
-
Dutch Orthopaedic Association
- NRS:
-
Numeric Rating Scale
- OA:
-
Osteoarthritis
- OKS:
-
Oxford Knee Score
- PROMs:
-
Patient-reported outcome measures
- PROs:
-
Patient-reported outcomes
- SD:
-
Standard deviation
- UKA:
-
Unicompartmental knee arthroplasty
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Acknowledgements
We would like to thank Klaartje van Diepen—Pijnappels and Maud Peters for their consistent data collection and kindness help to all patients in case of questions, and all patients for completing their PROMs.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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YP designed the study, supervised the performed data analysis and interpretation of data, and drafted the manuscript. AP performed the data analysis and interpretation of data supervised by YP, and revised the manuscript. JMB performed interpretation of data and revised the manuscript. All authors approved the final version of the manuscript.
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This is a retrospective study on the already collected data and all patients signed the informed consent to allow further scientific analysis using their anonymised data, and thus, the institutional review board deemed that formal approval was not required for this study.
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Pronk, Y., Paters, A.A.M. & Brinkman, JM. No difference in patient satisfaction after mobile bearing or fixed bearing medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 29, 947–954 (2021). https://doi.org/10.1007/s00167-020-06053-x
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DOI: https://doi.org/10.1007/s00167-020-06053-x