Yalım Ateş, Mutlu Akdoğan, Halis Atil Atilla

Which knee replacement do the patients forget? Unicondylar or total knee arthroplasty

Objective: The aim of this study was to determine which type of knee arthroplasty is easier to forget by comparing levels of joint awareness evaluated with the Forgotten Joint Score (FJS-12) after unicondylar versus total knee arthroplasty. Methods: Patients who underwent either unicondylar or total knee arthroplasty due to primary gonarthrosis were retrospectively identified and then divided into 2 groups: the TKA group (218 patients; mean age = 68.93 ± 7.14 years) and the UKA group (131 patients; mean age = 60.39 ± 7.03 years). The status of joint awareness after knee replacement surgery was assessed using the Turkish version of the FJS-12 at the final follow-up by telephone interview. Also, The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and The EuroQol five-dimensional (EQ-5D) scores were obtained to assess the clinical status of the patients. Results: The mean follow-up was 2.8 years (range = 24–49 months) in the TKA group and 3.2 years (range = 24–50 months) in the UKA group. The FJS-12 was significantly higher in the UKA group (73.60 ± 9.95) than in the TKA group (64.88 ± 9.47) (P = .001). The WOMAC score was significantly better in the UKA group (81.39 ± 9.84) than in the TKA group (74.92 ± 9.99) (P = .001). No significant difference in EQ-5D existed between the groups (0.76 ± 0.14 for the TKA group, 0.79 ± 0.17 for the UKA group; P = .441). In terms of gender, the FJS-12 showed no differences between the groups; however, more favorable scores were recorded in younger patients with UKA. Conclusion: The results of this study have demonstrated that UKA may be better than TKA in terms of the patient perception of pain, stiffness, and physical functioning.

PDF

___

1. Murray DW, Liddle AD, Dodd CAF, Pandit H. Unicompartmental knee arthroplasty: Is the glass half full or half empty? Bone Jt J. 2015;97-B(10 Suppl A):3-8. 10.1302/0301-620X.97B10.36542
2. Behrend H, Giesinger K, Giesinger JM, Kuster MS. The “Forgotten Joint” as the ultimate goal in joint arthroplasty. Validation of a new patient-reported outcome measure. J Arthroplasty. 2012;27(3):430436.e1. 10.1016/j.arth.2011. 06.035
3. Niama Natta DD, Thienpont E, Bredin A, Salaun G, Detrembleur C. Rasch analysis of the Forgotten Joint Score in patients undergoing knee arthroplasty. Knee Surg Sport Traumatol Arthrosc. 2019;27(6):1984-1991. 10. 1007/s00167-018-5109-x
4. Dai Y, Lin W, Yang GM, Lu JF, Wang F. Joint awareness after unicompartmental knee arthroplasty evaluated with the forgotten joint score. Orthop Surg. 2020;12(1):218-223. 10.1111/os.12613
5. Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and total knee arthroplasties: A propensity score-matched analysis. J Arthroplasty. 2017;32(5):1453-1459. 10.1016/j.arth. 2016.11.034
6. Wilson HA, Middleton R, Abram SGF, et al. Patient relevant outcomes of unicompartmental versus total knee replacement: Systematic review and meta-analysis. BMJ. 2019;364 21. 10.1136/bmj.l352
7. Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoǧlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil. 2005;13(1):28-33. 10.1016/j.joca.2004. 10.010 8. Kinikli G, Güney Deniz H, Karahan S, et al. Validity and reliability of Turkish version of the Forgotten Joint Score-12. Journal of Exercise Therapy and Rehabilitation. 2017;4(1):18-25. 10.1111/1756-185X.12962
9. Adriani M, Malahias MA, Gu A, Kahlenberg CA, Ast MP, Sculco PK. Determining the validity, reliability, and utility of the forgotten joint score: A systematic review. J Arthroplasty. 2020;35(4):1137-1144. 10.1016/j.arth.2019.10.058
10. Thomsen MG, Latifi R, Kallemose T, Barfod KW, Husted H, Troelsen A. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty. Acta Orthop. 2016;87 3 280-285. 10.3109/17453674. 2016.1156934
11. Zuiderbaan HA, Van Der List JP, Khamaisy S, et al. Unicompartmental knee arthroplasty versus total knee arthroplasty: Which type of artificial joint do patients forget? Knee Surg Sport Traumatol Arthrosc. 2017;25(3):681-686. 10. 1007/s00167-015-3868-1
12. Peersman G, Verhaegen J, Favier B. The forgotten joint score in total and unicompartmental knee arthroplasty: A prospective cohort study. Int Orthop. 2019;43(12):2739-2745. 10.1007/s00264-019-04342-w
13. Rosinsky PJ, Chen JW, Lall AC, Shapira J, Maldonado DR, Domb BG. Can we help patients forget their joint? Determining a threshold for successful outcome for the forgotten joint score. J Arthroplasty. 2020;35(1):153-159. 10.1016/j.arth. 2019.08.014
14. Baker P, Petheram T, Jameson S, Reed M, Gregg P, Deehan D. The association between body mass index and the outcomes of total knee arthroplasty. J Bone Joint Surg Am. 2012;94(16):1501-1508. 10.2106/JBJS.K.01180
15. Baker PN, Petheram T, Jameson SS, et al. Comparison of patient-reported outcome measures following total and unicondylar knee replacement. J Bone Jt Surg Ser B. 2012;94(7):919-927. 10.1302/0301-620X.94B7.28436
16. Murray DW, Pandit H, Weston-Simons JS, et al. Does body mass index affect the outcome of unicompartmental knee replacement? Knee. 2013;20(6):461- 465. 10.1016/j.knee.2012.09.017
17. Giesinger K, Hamilton DF, Jost B, Holzner B, Giesinger JM. Comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthr Cartil. 2014;22(2):184-189. 10.1016/j.joca.2013.11.001
18. Thienpont E, Zorman D. Higher forgotten joint score for fixed-bearing than for mobile-bearing total knee arthroplasty. Knee Surg Sport Traumatol Arthrosc. 2016;24(8):2641-2645. 10.1007/s00167-015-3663-z
19. Thienpont E, Vanden Berghe A, Schwab PE, Forthomme JP, Cornu O. Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ Score before and after joint replacement. Knee Surg Sport Traumatol Arthrosc. 2016;24(4):3346-3351. 10.1007/s00167-015-3970-4
20. French SR, Munir S, Brighton R. A single surgeon series comparing the outcomes of a cruciate retaining and medially stabilized total knee arthroplasty using kinematic alignment principles. J Arthroplasty. 2020;35(2):422-428. 10. 1016/j.arth.2019.09.021
21. Hamilton TW, Rizkalla J, Kontochristos L, et al. 0031 - the Interaction of caseload and usage in determining outcomes of unicompartmental knee arthroplasty: A meta-analysis. Knee. 2017;24(6):VI. 10.1016/j.knee.2017.08.021
22. Burn E, Liddle AD, Hamilton TW, et al. Choosing between unicompartmental and total knee replacement: What can economic evaluations tell us? A systematic review. PharmacoEconomics Open. 2017;1(4):241-253. 10.1007/ s41669-017-0017-4
23. Jessing IR, Mikkelsen M, Gromov K, Husted H, Kallemose T, Troelsen A. Patients with anteromedial osteoarthritis achieve the greatest improvement in patient reported outcome after total knee arthroplasty. Arch Orthop Trauma Surg. 2020;140 4 :517-525. 10.1007/s00402-020-03337-2
24. Liebensteiner M, Köglberger P, Ruzicka A, Giesinger JM, Oberaigner W, Krismer M. Unicondylar vs. total knee arthroplasty in medial osteoarthritis: A retrospective analysis of registry data and functional outcome. Arch Orthop Trauma Surg. 2020;140(4):545-549. 10.1007/s00402-020-03377-8
25. Ersan Ö., Öztürk A, Çatma MF, Ünlü S, Akdoğan M, Ateş Y. Total knee replacement—cementless tibial fixation with screws: 10-year results. Acta Orthop Traumatol Turc. 2017;51(6):433-436. 10.1016/j.aott.2017.10.008