Open AccessTen‐year patient‐reported outcomes following total and minimally invasive unicompartmental knee arthroplasty: a propensity score‐matched cohort analysis
Author(s) -
Burn Edward,
SanchezSantos Maria T.,
Pandit Hemant G.,
Hamilton Thomas W.,
Liddle Alexander D.,
Murray David W.,
PinedoVillanueva Rafael
Publication year - 2018
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-016-4404-7
Subject(s) - unicompartmental knee arthroplasty , medicine , oxford knee score , propensity score matching , arthroplasty , cohort , osteoarthritis , patient reported outcome , surgery , total knee arthroplasty , physical therapy , quality of life (healthcare) , alternative medicine , nursing , pathology
Purpose For patients with medial compartment arthritis who have failed non‐operative treatment, either a total knee arthroplasty (TKA) or a unicompartmental knee arthroplasty (UKA) can be undertaken. This analysis considers how the choice between UKA and TKA affects long‐term patient‐reported outcome measures (PROMs). Methods The Knee Arthroplasty Trial (KAT) and a cohort of patients who received a minimally invasive UKA provided data. Propensity score matching was used to identify comparable patients. Oxford Knee Score (OKS), its pain and function components, and the EuroQol 5 Domain (EQ‐5D) index, estimated on the basis of OKS responses, were then compared over 10 years following surgery. Mixed‐effects regressions for repeated measures were used to estimate the effect of patient characteristics and type of surgery on PROMs. Results Five‐hundred and ninety UKAs were matched to the same number of TKAs. Receiving UKA rather than TKA was found to be associated with better scores for OKS, including both its pain and function components, and EQ‐5D, with the differences expected to grow over time. UKA was also associated with an increased likelihood of patients achieving a successful outcome, with an increased chance of attaining minimally clinically important improvements in both OKS and EQ‐5D, and an ‘excellent’ OKS. In addition, for both procedures, patients aged between 60 and 70 and better pre‐operative scores were associated with better post‐operative outcomes. Conclusion Minimally invasive UKAs performed on patients with the appropriate indications led to better patient‐reported pain and function scores than TKAs performed on comparable patients. UKA can lead to better long‐term quality of life than TKA and this should be considered alongside risk of revision when choosing between the procedures. Level of evidence II.