Simultaneous ipsilateral knee arthroscopy and unicondylar knee arthroplasty is effective for bicompartmental symptoms.

BACKGROUND

Patients with unicompartmental radiographic arthritis but bicompartmental symptoms pose a clinical challenge. Some surgeons may perceive it as a contraindication for unicondylar knee arthroplasty (UKA). We investigated patient outcomes 2 years after simultaneous ipsilateral arthroscopy and UKA as compared to a similar group of patients who had total knee replacement (TKA) for a similar clinical presentation.

METHODS

We identified 9 patients with simultaneous ipsilateral arthroscopy and UKA between 2004 and 2013, and 12 clinically similar patients treated with TKA.

RESULTS

At 1- and 2-years, SF-12 physical scores were significantly improved in the UKA-scope group than in the TKA group (47.2 vs 40.3, p = 0.042; 48.3 vs 32.6, p = 0.026). WOMAC pain score, WOMAC stiffness score, WOMAC function and KSFS were significantly improved in the UKA-scope group at 2 years as compared to the TKA group (98.7 vs 63.8, p = 0.030), (90.1 vs 43.8, p = 0.013), (92.3 vs 55.2, p = 0.027 and (92.3 vs 55.2, p = 0.027), respectively). Change in score from baseline for KSFS, SF-12 physical and WOMAC stiffness were significantly improved in the UKA-scope group at 2 years compared to TKA, (28.3 vs -5, p = 0.041), (13.6 vs 3.0, p = 0.026), (52.6 vs -6.3, p = 0.025), respectively.

CONCLUSION

This study shows that patients with isolated compartment radiographic disease but with bicompartmental symptoms can benefit from UKA and simultaneous arthroscopy. Further, TKA for isolated compartment radiographic disease in this limited series had poorer outcomes. We obtain MRI selectively when physical exam and radiographic findings suggest isolated arthritic disease in patients with bicompartmental symptoms.