Aims and Objectives:
The purpose was to evaluate the clinical outcomes of patients with knee
osteoarthritis treated with bicompartmental arthroplasty (BKA) in comparison to
unicompartmental (UKA), patellofemoral (PFA) and total knee arthroplasty (TKA) in
a
single center.
Materials and Methods:
This is a prospective study analyzing a consecutive series of 396 patients from two
surgeons in a single center. In 191 men and 205 women either partial or total knee
replacement were performed. Their mean age at surgery was 63±6,85 years and mean BMI
29,55±5,00 kg/m2. In 238 patients UKA, in 125 TKA, in 21 PFA and in 11 patients BKA
was performed. Implants were cemented and made of cobalt chrome in partial knee and
zirconium oxide in total knee replacement. Demographics and patient reported
outcomes (VAS, KOOS, Oxford Knee Score (OKS)) were collected preoperatively and 3,6
and 12 months postoperatively. A total of 202 patients have thus far completed the
12 months follow-up time point.
Results:
All mean KOOS and OKS scores improved significantly 1 year after surgery (p<0.05).
Mean preoperative aggregated KOOS improved from 49,0±14,1 to 74,3±17,8 in UKA, from
44,1±12,9 to 67,5±9,4 in PFA, from 46,1±15,1 to 71,0±14,8 in TKA and from 45,7±13,8
to 72,6±9,7 in BKA (p<0.05). Mean preoperative aggregated OKS improved from
25,1±7,6) to 38,5±9,7 in UKA, from 23,0±7,6 to 36,8±3,8 in PFA, from 23,4±8,2 to
37,3±8,1 in TKA and from 22,9±9,6 to 37,0±1,5 in BKA (p<0.05). The mean pain
level (VAS)decreased from pre-treatment to 12 months after surgery in UKA from 5,5
to 1,6, in PFA from 6,1 to 2,5, in TKA from 6,0 to 1,9 and in BKA from 6,6 to 2,6.
One patient (0.4%) underwent revision (at 3 month for inlay dislocation).
Conclusion:
This study shows excellent early clinical results of patients treated with
unicompartmental, bicompartmental and total knee arthroplasty. Adherence to strict
indications lead to a significant improvement of patient reported outcomes and a low
revision rate one year postoperatively. The reported results for BKA are comparable
to those of patients treated with unicompartmental arthroplasty. We conclude that
bicompartmental arthroplasty is a safe and reliable surgery for patients with
bicompartmental osteoarthritis.