Unicompartmental Knee Arthroplasty in Octogenarians Is a Safe and Durable Procedure: Outcomes at 12-Year Follow-Up

The role of unicompartmental knee arthroplasty (UKA) in elderly patients remains debated due to concerns about comorbidities and implant durability. This study aimed to evaluate the safety, functional outcomes, and 12-year survivorship of medial UKA in patients over 80 years of age.

We retrospectively reviewed 151 consecutive patients aged ≥ 80 years who underwent medial UKA between 2008 and 2014 by a single experienced surgeon. After applying exclusion criteria, 115 knees were included. Clinical and radiographic assessments were performed preoperatively and at regular follow-up intervals. Functional outcomes were evaluated using the Knee Society Score, Oxford Knee Score, Forgotten Joint Score, visual analog scale, and range of motion. Kaplan-Meier analysis was used to estimate implant survivorship.

There were no major intraoperative or early postoperative complications observed. Functional scores and visual analog scale significantly improved postoperatively (P-values < 0.001) and were maintained at five years. Chronic analgesic use was discontinued in 87.5% of patients. At five years the radiographic progression of osteoarthritis in the lateral or patellofemoral compartments was mild, asymptomatic, and not statistically significant (P-values < 0.05). Implant survival, calculated on the basis of implant revision or patient death, was 96.3% (95% confidence interval, 92.7 to 98.1) at five and 12 years. There were four knees (3.4%) that required revision all beyond three years postoperatively.

A medial UKA in patients over 80 years of age is a safe, minimally invasive procedure associated with excellent functional outcomes, low complication and revision rates, and high 5-year patient satisfaction. A UKA should be considered a valid surgical option in this age group, even in the presence of moderate osteoarthritis in other compartments.