Our Summary

This research paper discusses a specific type of knee surgery called unicompartmental knee arthroplasty (UKA), which is used for a certain group of patients with osteoarthritis. Though this operation can be tricky, the results are generally good if patients meet the criteria for the surgery. The benefits of UKA, compared to a total knee replacement, include less health risks and a quicker recovery time. However, there can be complications such as dislocation of the mobile-bearing surface, the artificial knee joint becoming loose, and fractures around the artificial joint. If a second surgery is needed, it usually involves a total knee replacement, and the results are similar to those of revisions after a total knee replacement. This paper aims to summarize who should get UKA, what the results and possible problems are, as well as what happens if a second surgery is needed.

FAQs

  1. What are the benefits of unicompartmental knee arthroplasty (UKA) compared to total knee arthroplasty (TKA)?
  2. What are the potential complications of unicompartmental knee arthroplasty (UKA)?
  3. What does the revision procedure for unicompartmental knee arthroplasty (UKA) typically involve?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement surgery is to follow the post-operative rehabilitation plan diligently. This includes attending physical therapy sessions, doing prescribed exercises at home, and gradually increasing activity levels as directed by the healthcare team. Consistent rehabilitation is key to achieving optimal outcomes and regaining strength and mobility in the knee joint.

Suitable For

Patients who are typically recommended for knee replacement surgery, specifically unicompartmental knee arthroplasty (UKA), include those with localized osteoarthritis in one compartment of the knee joint. These patients may have symptoms such as pain, stiffness, and limited range of motion that have not responded to conservative treatment options. Additionally, patients should have good ligamentous stability and alignment in the affected compartment to be considered for UKA.

It is important for patients to be medically fit for surgery and willing to participate in postoperative rehabilitation to achieve optimal outcomes. Patients with severe osteoarthritis affecting multiple compartments of the knee joint or those with inflammatory arthritis may be better candidates for total knee arthroplasty (TKA) instead.

Overall, UKA is a good option for carefully selected patients with isolated compartmental osteoarthritis, as it offers several advantages over TKA, including lower morbidity, faster recovery, and preservation of healthy bone and soft tissue. However, potential complications should be considered, and patients should be counseled on the risks and benefits of the procedure before undergoing surgery.

Timeline

Before knee replacement surgery:

  • Patient experiences chronic knee pain and stiffness that does not improve with conservative treatments such as physical therapy, medications, or injections.
  • Patient undergoes a thorough evaluation by an orthopedic surgeon to determine if they are a candidate for knee replacement surgery.
  • Pre-operative tests and imaging studies are conducted to assess the severity of arthritis in the knee joint.
  • Patient participates in pre-operative education and preparation to understand the procedure, risks, and rehabilitation process.

After knee replacement surgery:

  • Patient undergoes the surgical procedure to remove damaged cartilage and bone in the knee joint and replace it with an artificial implant.
  • Patient stays in the hospital for a few days for monitoring and initial rehabilitation.
  • Patient begins physical therapy and rehabilitation to regain strength, flexibility, and mobility in the knee.
  • Patient may experience some pain, swelling, and discomfort during the initial recovery period.
  • Over the following weeks and months, patient gradually improves their range of motion and function in the knee.
  • Patient continues with physical therapy and exercises to strengthen the muscles around the knee and prevent complications.
  • Patient gradually resumes normal activities and may experience significant improvement in pain and mobility compared to before the surgery.

What to Ask Your Doctor

  1. What are the indications for a unicompartmental knee arthroplasty (UKA) compared to a total knee arthroplasty (TKA)?
  2. What are the potential benefits of UKA compared to TKA in terms of recovery time and morbidity?
  3. What are the potential complications associated with UKA, such as dislocation of the mobile-bearing surface, prosthesis loosening, and periprosthetic fracture?
  4. What is the likelihood of needing revision surgery after UKA, and what does the revision process typically involve?
  5. What are the expected outcomes after revision surgery following a UKA, particularly in terms of comparison to revisions after TKA?
  6. What is the expected recovery time and rehabilitation process after UKA surgery?
  7. Are there any specific lifestyle modifications or precautions that should be taken after UKA surgery?
  8. What is the long-term prognosis for a patient who undergoes UKA surgery?
  9. How frequently will follow-up appointments be needed after UKA surgery, and what will be monitored during these appointments?
  10. Are there any alternative treatment options to consider before proceeding with UKA surgery?

Reference

Authors: Tyagi V, Farooq M. Journal: Conn Med. 2017 Feb;81(2):87-90. PMID: 29738151