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Retrospective analysis of return to impact sport after medial unicompartmental knee arthroplasty based on a cohort of 92 patients - 20/05/23

Doi : 10.1016/j.otsr.2023.103577 
Axel Schmidt, Christophe Jacquet, Charles Pioger, Sébastien Parratte, Jean-Noel Argenson, Matthieu Ollivier
 Institute for Locomotion, Center for Arthritis Surgery, Sainte-Marguerite Hospital, Marseille, France 

Corresponding author: Institute of movement and locomotion, Department of Orthopedics and Traumatology, Sainte-Marguerite Hospital, 270, boulevard Sainte-Marguerite, 13274 Marseille, France.Institute of movement and locomotion, Department of Orthopedics and Traumatology, Sainte-Marguerite Hospital270, boulevard Sainte-MargueriteMarseille13274France

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Abstract

Background

Return to sport after Knee Arthroplasty has been investigated reporting modifications in the physical activities with a trend towards to lower impact sports after Unicompartemental Knee Arthroplasty. The purpose of this study was to analyze the return to sport level after medial unicompartmental knee arthroplasty (MUKA) in a population of osteoarthritic patients having practiced impact sport, defined with a University of California at Los Angeles activity scale (UCLA)9 in their pre-symptomatic arthritic period.

Hypothesis

Return to an impact sport after MUKA was possible for a population of osteoarthritic patients having practiced impact sport in their pre-symptomatic arthritic period.

Methods

Ninety-two MUKA with a pre-symptomatic arthritic UCLA score9, including 60 men (65.2%) and operated between January 2009 and September 2014, were evaluated by a dedicated survey. Informations were obtained concerning the physical activities (intensity, frequency, kind of sport, reasons to decrease or stop the physical activities in the pre- and the postoperative period). The average age was 64.9 years±6.4 (range 49–74.4). Three different periods were compared: pre-symptomatic arthritic, preoperative and postoperative period. The mean follow-up was 7.3±1.7 years.

Results

The mean pre-symptomatic arthritic UCLA score was 9.9±0.3, the mean preoperative UCLA score was 7.0±2.5 (2–10) and the mean postoperative UCLA score was 7.2±2.0 (3–10). There were significant differences for the mean UCLA score values between pre-symptomatic arthritis and postoperative UCLA scores (p=0.034), however no difference was detected in mean score values before and after surgery (p=0.09). Only 32.6% (30/92) of patients had a postoperative UCLA score9. For patients practicing an impact sport activity (UCLA9) in the preoperative period (23/92; 25%), the postoperative UCLA score was at 8±1.1 (range 4–10). In this subgroup, 47.8% (11/23) of patients had a postoperative UCLA score9. The decline in sports in postoperative was predominantly explained by residual pain of the operated knee (31/92; 34%), precaution to not damage the prosthesis (25/92; 27%) and restrictions due to another joint (19/92; 21%).

Discussion

Return to impact sport after MUKA seems to be limited to a restrained number of patients. The main reasons to the decline in sporting activity level are linked to the residual pain of the operated knee and the precaution to not damage the prosthesis.

Level of evidence

IV, retrospective cohort study.

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Keywords : Unicompartmental knee arthroplasty, Return to sport, Impact sport activity, UCLA scale, Quality of life


Plan


 Investigation performed at: Aix Marseille Univ, AP–HM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, Marseille, France.


© 2023  Elsevier Masson SAS. Tous droits réservés.
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Vol 109 - N° 4

Article 103577- juin 2023 Retour au numéro
Article précédent Article précédent
  • Unicompartmental knee arthroplasty: A French multicenteric retrospective descriptive study from 2009 to 2019 with projections to 2050
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| Article suivant Article suivant
  • Medial unilateral knee arthroplasty after high tibial osteotomy: A retrospective study of 41 cases
  • Julie Chan-Waï-Nam, Marie Fernandez, Antoine Josse, Frédéric Dubrana

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