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Elderly patients show similar results as younger patients with mobile bearing UKA
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Researchers in this study found comparable results with using mobile bearing unicompartmental knee arthroplasty in an elderly population compared to younger patients.
“This study concludes that patients aged 80 or older should be considered for [mobile bearing unicompartmental knee] MBUK arthroplasty if they fulfill the described criteria,” the researchers wrote in the study. “The results and outcomes of the MBUKA in the elderly (80+ years) are predictable and comparable with those of the younger population.”
The objective component of the American Knee Society Score in the patients improved from 32.55 points to 85.21 points at 1-year follow-up and was maintained through 3-year and 5-year follow-up times. The functional component of this score was calculated separately and were improved from mean 45 points to 59.78 points at 1 year, 65.81 points at 3 years before decreasing to 60.38 at 5-year follow-up.
Regarding complications, the study group had a higher complication rate over other groups. However, the researchers wrote that the complications were not orthopedic-related. When counting for implant-related complications, the elderly MBUKA group had lower complications over the younger patients.
Disclosure: The authors have no relevant financial disclosures.
Perspective
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Arun Mullaji, FRCS Ed, MS Orth
Unicompartmental knee arthroplasty, in my opinion and based on my personal experience with nearly 300 unicompartmental knee arthroplasties, is an excellent option for medial compartmental arthritis. The results are heavily dependent on patient selection in terms of the extent of involvement of the remaining joint, especially an intact ACL, precise technique with care to avoid over-correction and use of an implant that has performed well. The age of the patient is not an important consideration as long as they are not too young, as revision rates are higher in younger, active individuals. It can certainly be done in older patients as it has lesser morbidity, quicker recovery and results are equally good as shown in this study.
Perspective
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Johan Bellemans, MD, PhD
This is an interesting study. Many surgeons would go for the “safer” option of total knee arthroplasty in the octogenarian. At that age most patients would indeed have at least some wear in the rest of the knee, as well. So why not replace everything? It is interesting to note that the outcome of unicompartmental knee arthroplasty (UKA) in these Scottish patients was very good. In fact, their results were as good as those for the more commonly accepted age group for a “uni,” which is the middle-aged patient. This study, therefore, confirms a previous, but unpublished work by Richard D. Scott, MD. He, too, had noted excellent results in octogenarians treated with UKA.
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