Bezmiâlem Science (Jan 2019)
Comparison of Clinical Outcomes and Safety of Single-stage Bilateral and Unilateral Unicompartmental Knee Arthroplasty
Abstract
Objective:To evaluate the effectiveness and safety of bilateral Oxford medial unicompartmental knee arthroplasty (UKA) in the patients under a single anesthetic procedure.Methods:Between October 2013 and December 2015, 225 knees of 181 (age 67.5 years) patients with at least two years of followup were evaluated. They were divided into two groups as unilateral group (group 1, n=137) and one-stage simultaneous bilateral group (group 2, n=44) for the comparisons. The outcome parameters were femoral and tibial component positions measured on the full-length radiographs, clinical outcomes using Oxford Knee Score (OKS), International Knee Documentation Committee Score (IKDC), patient reported satisfaction and complications.Results:Between the groups, the mean follow-up periods (p=0.125), age (p=0.447), preoperative body mass index (p=0.288), OKS (p=0.314) and IKDC (p=0.127) scores were not significantly different. Postoperatively, the mean flexion of the femoral component (p=0.544), posterior slope (p=0.511), varus-valgus angulation of the tibial components (p=0.358) were statistically similar between groups. Although the mean varus-valgus angulation of the femoral components (p=0.033) was statistically different between groups, the difference was too small to make clinical significance. The mean postoperative OKS (p=0.272) and IKDC (p=0.106) were similar between the groups. In group 1, 21 (16.0%) patients reported excellent, 91 (69.5%) good and 4 (3.1%) moderate satisfaction. Fifteen (11.5%) patients reported non-satisfaction. In group 2, patients reported excellent satisfaction in 20 (24.4%) knees, good in 50 (61.0%) knees patients moderate in 2 (2.4%) knees. Patients reported non-satisfaction in 10 (12.2%) knees (p>0.05). Eight (5.8%) complications in group 1 and, 3 (3.4%) complications in group 2 were observed. The number of complications was not statistically different between the groups (p=0.535).Conclusion:One-stage simultaneous bilateral Oxford medial UKA is a safe and effective method with acceptable complication rates compared to unilateral surgery.
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