Unicompartmental Knee Arthroplasty Vs. Total Knee Arthroplasty for Medial Compartment Arthritis in Patients Older Than 75 Years: Comparable Reoperation, Revision, and Complication Rates

In The Journal of Arthroplasty, Homayoun Siman and colleagues, including Atul Kamath, assess the effectiveness of unicompartmental knee arthroplasty (UKA) vs. total knee arthroplasty (TKA) in similar patients. Prior studies have shown that UKA procedures have advantages over TKA, including preservation of bone stock, shorter and easier recovery, lower overall cost, lower morbidity, better functional outcome, and subjective feeling of a more natural knee. The authors conducted a retrospective review of patients 75 years and older who underwent UKA or TKA over a 10-year period in one institution. The final sample included 106 UKA patients and 170 TKA patients, whose records were reviewed to determine early postoperative recovery, complications, re-operations for any reason, and implant survivorship. The authors find that UKA patients experienced a significantly shorter operative time, shorter hospital stay, lower intraoperative estimated blood loss, lower postoperative transfusions, greater postoperative range of motion, and higher level of activity at time of discharge. There were no differences in 5-year survivorship estimates. The authors conclude that, due to its less invasive nature, patients older than 75 undergoing UKA demonstrated faster initial recovery when compared to TKA, while maintaining comparable complications and midterm survivorship. UKA should be offered as an option in the elderly patient who fits the selection criteria for UKA.