Effects of unicondylar and total knee arthroplasty on knee osteoarthritis

Abstract

Objective To compare the therapeutic effects of unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) on knee osteoarthritis (KOA) to provide references for the clinical selection of the best surgical approach. Methods A total of 104 KOA patients who underwent knee arthroplasty at Shijiazhuang People's Hospital from February 2020 to February 2021 were selected. Patients were divided into three groups based on the classification and lesion location of KOA: unicompartment lesion group (36 cases, undergoing patellofemoral joint replacement or UKA), two compartments lesion group (35 cases, undergoing simultaneous two compartments knee arthroplasty), and three compartments lesion group (33 cases，undergoing TKA). The postoperative recovery of joint function was followed up for 18 months. The range of motion (ROM), American Knee Society Score clinical score, KSS functional score, Japanese Orthopedic Association Assessment (JOA) score of knee joint, and serum interleukin (IL)-6 and IL-7 levels of patients were compared among three groups before and after surgery. Results After surgery, the ROM score, KSS clinical score, and KSS functional score, and JOA score of knee joint function in the three groups increased compared to preoperative values, with those in unicompartment lesion group and two compartments lesion group being higher than in three compartments lesion group (P＜0.05). After surgery, the excellent and good rate in the unicompartment lesion group, the two compartments lesion group and the three compartments lesion group were 72.22%, 74.29% and 66.67%, respectiuely. There was no statistically significant difference in clinical efficacy among the three groups (χ2=0.510, P=0.774). After surgery, the serum levels of IL-6 and IL-7 in the three groups significantly decreased compared to preoperative levels, with those in unicompartment lesion group and two compartments lesion group being lower than three compartments lesion group (P＜0.05). Conclusion Both UKA and TKA can achieve good therapeutic effects in the treatment of KOA. Choosing the appropriate surgical approach based on the classification and lesion location of knee joint diseases can better promote the recovery of knee joint function and achieve better treatment results in KOA patients.

Keywords

• unicompartmental knee arthroplasty
• total knee arthroplasty
• knee osteoarthritis
• knee joint function
• patellofemoral joint replacement