JOA - 2026-04-09 - Journal Article
Clinical Outcomes of Fixed-Bearing Medial Unicompartmental Knee Arthroplasty in Patients Older than 80 Years: A Matched Control Study.
Tsikopoulos K, Kazamias MK, Hasan MK, White P, Putnis MS
Topics
Key Takeaway
Fixed-bearing medial UKA in patients >80 years yields OKS improvement equivalent to patients ≤70 years at 5 years, with a non-significant revision risk ratio of 0.57 (95% CI 0.174–1.876).
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Summary
This study compared clinical outcomes of cemented fixed-bearing medial UKA in patients >80 years versus ≤70 years using prospectively collected data from 2004–2017. Primary outcome was OKS at 5 years; secondary outcomes included revision rate, complications, and 10-year mortality. Mean OKS difference between groups was 0.1 (95% CI -4.06 to 4.26, P=0.962), with 4 revisions in the elderly group versus 7 in controls (RR 0.57, P=0.356), and no procedure-related deaths.
Key Limitation
The study is underpowered to detect meaningful differences in revision rate, as the wide confidence interval (RR 0.174–1.876) precludes definitive equivalence conclusions.
Original Abstract
INTRODUCTION
Unicompartmental knee arthroplasty (UKA) has a proven track record of success in patients who have medial knee osteoarthritis. However, it is still unclear whether outcomes in elderly patients are as satisfactory five years postoperatively and beyond as those in younger patients. In this study, we compared these two groups undergoing fixed-bearing cemented medial UKA.
METHODS
Prospectively collected data from cemented fixed-bearing medial UKAs collected between 2004 and 2017. Patients older than 80 years of age were matched with a control group of patients 70 years old or younger. The primary outcome was the Oxford Knee Score (OKS), and secondary outcome measures were complication rate, revision rate, and mortality within the first 10 years. A total of 160 patients were included who had a 1:1 ratio between the study and the body mass index (BMI)- and sex-matched control groups. The mean follow-ups were 97.3 months (range, 6 to 180) and 123 months (range, 0 to 180) for the 80-plus-year-old and control groups, respectively.
RESULTS
Excellent clinical improvement was demonstrated in both groups (mean difference in OKS five years postoperatively was 0.1 (95% CI [confidence interval], -4.06 to 4.26, P = 0.962). There were four and seven revisions performed in the 80 years and above and control groups, respectively (relative risk of 0.57 (95% CI, 0.174 to 1.876, P = 0.356). There were no deaths related to the index procedure.
CONCLUSIONS
This study shows comparable clinical outcomes five years postoperatively between patients aged above 80 and 70 years of age or below following fixed-bearing UKA. Comparable implant survivorship, revision rates, and surgical and medical complication profiles were documented in the immediate postoperative period. Fixed-bearing medial UKA appears to be a safe and effective option for more elderly patients who have medial knee OA.