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Better Quality of Life After Medial Versus Lateral Unicondylar Knee Arthroplasty

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The number of unicompartmental knee arthroplasties (UKAs) is growing worldwide. Because lateral UKAs are performed much less frequently than medial UKAs, the limited information leaves unclear whether UKAs have comparable survival and health-related quality of life (HRQoL) of the lateral UKA to medial UKAs.

Questions/purposes

We therefore compared the (1) survivorship and (2) HRQoL after lateral versus medial cemented mobile-bearing UKAs and (3) determined whether there is an association of survival to modifications of surgical technique in one of three phases.

Methods

We retrospectively reviewed 558 patients who underwent mobile-bearing UKAs from 2002 to 2009. From the records we determined revision of the joint for any reason and revision for aseptic loosening. Patients reported their physical function, pain, and stiffness as measured by the WOMAC, SF-36 physical-component summary (PCS), and Lequesne knee score. Information regarding implant survival was collected for 93% of the patients. We analyzed the patients separately by three phases based on surgical changes associated with each phase (1: initial technique; 2: improved cementing; 3: additional bone resection to ensure backward sliding of the inlay without impingement). The minimum followup was 2.1 years (mean, 6 years; range, 2.1–9.8 years).

Results

Implant survival was 88% at 9 years. We found similar implant survival rates for medial (90%) and lateral UKAs (83%). In all HRQoL measures, patients receiving a medial UKA had better mean scores compared with patients who had a lateral UKA: WOMAC physical function (23 versus 34, respectively) and pain (21 versus 34) and SF-36 PCS (41 versus 38). There were no survival differences by surgical phase.

Conclusions

Our observations suggest a medial UKA is associated with superior HRQoL when compared with a lateral UKA, although implant survival is similar.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Schleswig-Holstein Medical Center, Kiel Campus, Michaelisstr 1, 24105, Kiel, Germany

    Thoralf R. Liebs MD

  2. Department of Orthopaedic Surgery, Asklepios Westklinikum Hamburg, Hamburg, Germany

    Wolfgang Herzberg MD

Authors
  1. Thoralf R. Liebs MD
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  2. Wolfgang Herzberg MD
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Corresponding author

Correspondence to Thoralf R. Liebs MD.

Additional information

One of the authors (TRL) certifies that he has or may receive payments or benefits, during the study period, an amount of USD 10,000–USD 100,000, from DePuy International Ltd (Leeds, UK).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Department of Surgery, Wedel Hospital, Wedel, Germany, and Department of Orthopaedic Surgery, Asklepios Westklinikum Hamburg, Hamburg, Germany.

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Liebs, T.R., Herzberg, W. Better Quality of Life After Medial Versus Lateral Unicondylar Knee Arthroplasty. Clin Orthop Relat Res 471, 2629–2640 (2013). https://doi.org/10.1007/s11999-013-2966-y

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