TKA is More Durable Than UKA for Morbidly Obese Patients: A Two-Year Minimum Follow-Up Study

Jan 23, 2021The Journal of arthroplasty

Total Knee Replacement Lasts Longer Than Partial Replacement in Severely Obese Patients Over at Least Two Years

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Abstract

UKA was associated with 29.2% clinical failure compared to 2.5% for TKA.

UKA had a higher component revision rate of 15.7% versus 2.5% for TKA.
TKA was linked to more extensor mechanism complications or knee manipulation (5.5% vs 0.0%).
Infection rates were similar between UKA and TKA, at 3.0% and 2.2%, respectively.
Early complications were lower after UKA, but the higher revision rates suggest TKA may offer better mid-term outcomes for morbidly obese patients.

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BACKGROUND: Unicompartmental knee arthroplasty (UKA) indications have expanded during the past two decades to include some morbidly obese patients (body mass index (BMI) > 40 kg/m). Few published studies have compared UKA and total knee arthroplasty (TKA) in this unique patient subgroup with conflicting observations. 2

METHODS: We retrospectively compared 89 mobile bearing UKA (71 patients) and 201 TKA (175 patients) performed at a single institution with a minimum 2-year follow-up (mean 3.4 years). Demographic characteristics were similar for both patient cohorts. A detailed medical record review was performed to assess the frequency of component revision, revision indications, minor secondary procedures (components retained), and infections.

RESULTS: UKA was more frequently associated with clinical failure (29.2% vs 2.5%, P < .001) and component revision (15.7% vs 2.5%, P < .001), TKA was more frequently associated with extensor mechanism complications or knee manipulation (5.5% vs 0.0%, P = .02), and there was no difference in the infection rate (3.0% vs 2.2%, P = 1.0).

CONCLUSION: Early complications were lower following UKA but were outweighed by higher component revision rates for arthritis progression and implant failure. The study findings suggest that TKA provides a more predictable mid-term outcome for morbidly obese patients considering knee arthroplasty surgery.

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TKA is More Durable Than UKA for Morbidly Obese Patients: A Two-Year Minimum Follow-Up Study

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