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Introduction <p>The widely accepted indications for unicompartmental knee arthroplasty (UKA) emphasize bone-on-bone contact, and early osteoarthritis (OA) of Kellgren–Lawrence (KL) grade ≤ 2 is considered a contraindication. The present study aimed to clarify the differences in clinical outcomes of UKA between patients with early OA (KL ≤ 2) and those with advanced OA (KL ≥ 3), the latter representing the conventional indication for this procedure.</p> Materials and Methods <p>Eighty-four UKA patients with ≥ 1&#xa0;year follow-up were retrospectively divided into early OA (KL ≤ 2; n = 32) and advanced OA (KL ≥ 3; n = 52) groups. Preoperative magnetic resonance imaging (MRI) was used to examine meniscal and cartilage lesions. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analog scale pain score, both preoperatively and at the final evaluation. Patient characteristics, clinical scores, and changes in clinical scores were compared between the early OA (KL ≤ 2) and advanced OA (KL ≥ 3) groups.</p> Results <p>The early OA (KL ≤ 2) group (n = 32) had a mean age of 70.5&#xa0;years with 35.3&#xa0;months’ follow-up, while the advanced OA (KL ≥ 3) group (n = 52) had 70.0&#xa0;years with 31.6&#xa0;months (both 12–60&#xa0;months). The early OA (KL ≤ 2) group showed a high incidence of medial meniscus posterior root tears (MMPRT; 75.0%) and subchondral insufficiency fractures (SIFK; 56.3%). After false discovery rate (FDR) adjustment, preoperative and postoperative clinical scores did not differ significantly between groups. However, the change in KOOS-sports and recreation function (Sport/Rec) was significantly higher in the early OA (KL ≤ 2) group compared with the advanced OA (KL ≥ 3) group (<i>P</i> = 0.020 after FDR adjustment). The effect sizes were 0.55 for KOOS-Sport/Rec.</p> Conclusions <p>UKA may be considered for carefully selected patients with MRI-confirmed medial compartment lesions and early OA (KL ≤ 2), but these results should be interpreted cautiously pending long-term, multicenter validation.</p>

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Clinical outcomes of unicompartmental knee arthroplasty in early osteoarthritis without bone-on-bone contact

  • 期刊论文

  • 发表日期：

    2025年12月24日

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  • Koki Kawada,
  • Takayuki Furumatsu,
  • Yusuke Yokoyama,
  • Yuki Okazaki,
  • Kazuhisa Sugiu,
  • Toshiki Kohara,
  • Toshifumi Ozaki

摘要

Introduction

The widely accepted indications for unicompartmental knee arthroplasty (UKA) emphasize bone-on-bone contact, and early osteoarthritis (OA) of Kellgren–Lawrence (KL) grade ≤ 2 is considered a contraindication. The present study aimed to clarify the differences in clinical outcomes of UKA between patients with early OA (KL ≤ 2) and those with advanced OA (KL ≥ 3), the latter representing the conventional indication for this procedure.

Materials and Methods

Eighty-four UKA patients with ≥ 1 year follow-up were retrospectively divided into early OA (KL ≤ 2; n = 32) and advanced OA (KL ≥ 3; n = 52) groups. Preoperative magnetic resonance imaging (MRI) was used to examine meniscal and cartilage lesions. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analog scale pain score, both preoperatively and at the final evaluation. Patient characteristics, clinical scores, and changes in clinical scores were compared between the early OA (KL ≤ 2) and advanced OA (KL ≥ 3) groups.

Results

The early OA (KL ≤ 2) group (n = 32) had a mean age of 70.5 years with 35.3 months’ follow-up, while the advanced OA (KL ≥ 3) group (n = 52) had 70.0 years with 31.6 months (both 12–60 months). The early OA (KL ≤ 2) group showed a high incidence of medial meniscus posterior root tears (MMPRT; 75.0%) and subchondral insufficiency fractures (SIFK; 56.3%). After false discovery rate (FDR) adjustment, preoperative and postoperative clinical scores did not differ significantly between groups. However, the change in KOOS-sports and recreation function (Sport/Rec) was significantly higher in the early OA (KL ≤ 2) group compared with the advanced OA (KL ≥ 3) group (P = 0.020 after FDR adjustment). The effect sizes were 0.55 for KOOS-Sport/Rec.

Conclusions

UKA may be considered for carefully selected patients with MRI-confirmed medial compartment lesions and early OA (KL ≤ 2), but these results should be interpreted cautiously pending long-term, multicenter validation.