Unicompartmental knee arthroplasties in Hong Kong: 15 years of experience in a teaching hospital

Abstract

Introduction: Osteoarthritis (OA) of the knee is a growing problem in an aging population. Unicompartmental knee arthroplasties (UKA) have been used for management of isolated OA of the medial tibiofemoral joint. This is the first study on the usage of UKA in Hong Kong.

Methods: Retrospective analysis of all patients undergoing medial compartment UKA in a tertiary referral center since 2003. Preoperative and postoperative International Knee Society Knee Scores (KSKS) and Knee Societal Functional Assessment (KSFA) scores, range of motion, flexion deformity, and lower limb mechanical alignment were measured. Statistical analysis using paired sample t-tests was performed. Revision operations, rate of revisions, and causes of failure were analyzed. Univariate and multivariate logistic regression analyses of risk factors for revision operation were performed against patient demographics, type of prosthesis, postoperative alignment, and degree of correction.

Results: There were 94 UKA performed with an average follow-up of 4.3 years (range: 0.5–15.2 years). The KSKS and KSFA scores improved from 54.5 and 54.0 to 85.6 and 64.5 (p < 0.01), respectively. There was no significant improvement in the range of motion (p = 0.87) and fixed flexion deformity (p = 0.14). Mechanical alignment improved from 172.1° to 174.9° varus postoperatively (p < 0.01). Six cases required revision operation with a revision rate of 1.50 per 100 observed component years. Causes of revision included two cases of tibial tray loosening and one case each of progressive OA, mechanical failure, persistent pain, and infection. Logistic regression analysis for risk factors showed no statistical significance.

Conclusions: UKA offers good functional improvement but further long-term studies are required to evaluate survivorship.