UNICOMPARMENTAL KNEE REPLACEMENT VS TOTAL: INDICATIONS AND CONTRAINDICATIONS

Abstract

Introduction. Unicompartmental knee arthroplasty (UKA) has become increasingly popular in the treatment of a number of knee joint diseases, especially in the last few years. The purpose of the study is to evaluate the results of UKA, to evaluate the indications and contraindications for OEC of the knee joint. Research materials and methods. The study included 128 patients with a diagnosis of gonarthrosis, aged from 40 to 79 years (average age 63.2 ±5.4 years). Of these, 56 patients underwent UKA, and 72 underwent total arthroplasty. Results. It has been established that there are significant differences in the results of knee arthroplasty. On average, these differences are revealed after 7 years, as shown by the assessment on the visual analog scale VAS, as well as the scales WOMAC, KKS, IKDC. It has been found that there is less pain during high-intensity exercise for patients with UKA, such activities include climbing or descending stairs, as well as moving over long distances. on average, the duration of gonarthrosis among patients with total arthroplasty was 2.5 times longer, while among patients with UKA, those with the second stage of the disease were 4 times more frequent. Patients with total arthroplasty more often had a mixed contracture, while patients with UKA more often had a flexion or extensor contracture. Among patients with UKA, a more dynamic gait was noted, they did not use crutches, but 60% of them used a stick. Analysis of long-term outcomes also showed significant differences in favor of patients with OEC. In particular, the Knee Society score scale showed a tendency to increase from 57 (in the range of 42-94 points) points before surgical intervention to 89 (62-98) points after. An increase in functional indicators was also noted from 60 before the operation (46-95) to 89 (56-99) after. Oxford scale scores also increased, from 26 (13-40) before surgery to 41 (29-55) after it. Before surgery, range of motion indicators were 130° (within 121°-136°), while after surgery they were 136° (119°-143°). Conclusions. UKA takes more and more place in the treatment of knee arthrosis. This is explained by the greater "physiological" nature of the operation as it does not change the biomechanics of the knee, the expansion of indications for it, the development of new technologies and modern materials, and a considerable percentage of "dissatisfaction" after total knee arthroplasty.