Comparison of implant position and joint awareness between fixed- and mobile-bearing unicompartmental knee arthroplasty:
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ORIGINAL PAPER
Comparison of implant position and joint awareness between fixedand mobile-bearing unicompartmental knee arthroplasty: a minimum of five year follow-up study Man Soo Kim 1 & In Jun Koh 2 & Chul Kyu Kim 1 & Keun Young Choi 1 & Jong Won Baek 1 & Yong In 1 Received: 20 February 2020 / Accepted: 11 June 2020 # SICOT aisbl 2020
Abstract Purpose To compare the implant position and patient-reported outcomes (PROs) regarding joint awareness using the Forgotten Joint Score (FJS) following between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) with a minimum of five years’ follow-up. Methods One hundred fifteen consecutive UKAs (58 FB UKAs and 57 MB UKAs) performed were retrospectively evaluated. We compared the radiographic parameters including component positions and relationships as well as lower extremity alignment. Post-operative clinical outcomes were assessed using Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Tegner activity score, and FJS. Results The MB UKA group showed more convergent componentry relationship between femoral and tibial components (p < 0.001). The joint line of the MB UKA group was restored significantly better (p < 0.05). In addition, the positioning of femoral and tibial components of the MB UKA group showed less deviation from the weight-bearing line (WBL) (p < 0.05). Although there were no differences in KSS, WOMAC, and Tegner activity scores between the groups, the MB UKA group showed significantly better FJS than did the FB UKA group at five years post-operatively (p < 0.05). Conclusion The MB UKA group had a more convergent componentry relationship, less deviation from WBL, better joint-line restoration, and reduced joint awareness than did the FB UKA group at five years follow-up. Keywords Fixed-bearing . Mobile-bearing . Unicompartmental knee arthroplasty . Joint awareness . Forgotten joint score
Introduction There are two basic designs in unicompartmental knee arthroplasty (UKA): fixed-bearing (FB) and mobile-bearing (MB) UKA. There is controversy about which design is superior between FB and MB UKA for patients with unicompartmental knee osteoarthritis (OA) [1, 2]. Recently, both FB and MB UKA systems have been improved [3, 4]. Level of evidence: III * Yong In [email protected] 1
Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
2
Department of Orthopaedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021,Tongil Ro, Eunpyeong-gu, Seoul 03312, Republic of Korea
Although some studies have compared FB and MB UKAs using patient-reported outcomes (PROs) [5–9], there is little data about PROs with a minimal ceiling effect, such as joint awareness between up-to-date FB and MB UKAs, which is increasingly being considered as an essential part of postoperative outcome evaluation [10]. The Forgotten Jo
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