Unicompartmental knee arthroplasty in patients over 75 years: a definitive solution?
BACKGROUND
The purpose of this study was to perform a mid-long-term clinical and radiographic evaluation of the results obtained in patients older than 75 years treated with minimally invasive unicompartmental knee arthroplasty (UKA). The hypothesis was that UKA is a viable solution for the definitive treatment of localized disease in this age group, with good results and a low failure rate.


METHODS
An all-poly tibial component UKA was applied with a minimally invasive technique. Sixty-seven knees in patients with a minimum age of 75 years were evaluated at mean 9 years' follow-up. The Oxford knee score, Knee Society Score, WOMAC score, Visual Analogue Scale (VAS) for pain self-assessment and range of motion (ROM) were determined, as well as weight-bearing antero-posterior and laterolateral radiographs.


RESULTS
All clinical scores, as well as VAS and ROM, improved significantly at 9-year follow-up, and the outcome was considered good or excellent in 92.6% of the patients. Radiographic results showed that both tibial plateau angle and posterior tibial slope angles were maintained, whereas femoro-tibial angle was significantly changed at follow-up. Further analysis showed no significant correlation between clinical scores and body mass index, whereas the clinical outcome was correlated with the ROM obtained. Only two failures and one major post-operative complication were observed.


CONCLUSIONS
UKA is a viable option for treating unicompartmental knee osteoarthritis. With the proper indications and an accurate technique UKA may be indicated also in very elderly patients with reduced complications and morbidity, and excellent survivorship.
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. f.iacono@biomec.ior.it.
Francesco
F
Iacono
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. giovi.ras@hotmail.it.
Giovanni Francesco
GF
Raspugli
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. ibrahim.akkawi@studio.unibo.it.
Ibrahim
I
Akkawi
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. d.bruni@biomec.ior.it.
Danilo
D
Bruni
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. g.filardo@biomec.ior.it.
Giuseppe
G
Filardo
Orthopaedics and Traumatology Department, SANKO University-Private Sani Konukoglu Hospital, Gaziantep, Turkey. budeyriaydin@yahoo.com.
Aydin
A
Budeyri
Dipartimento di Scienze Biomediche e Neuromotorie-DIBINEM, Univeristà di Bologna, Bologna, Italy. l.bragonzoni@biomec.ior.it.
Laura
L
Bragonzoni
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. m.lopresti@biomec.ior.it.
Mirco Lo
ML
Presti
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. raviortho1980@gmail.com.
Tommaso
T
Bonanzinga
2 nd Orthopaedics and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136, Bologna, Italy. m.marcacci@biomec.ior.it.
Maurilio
M
Marcacci
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
Age; Elderly; Knee; Osteoarthritis; Osteonecrosis; Unicompartmental knee arthroplasty