Background: 

Comparisons of functional recovery between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) using performance-based tests are lacking. Therefore, this study aimed to compare 2-minute walk test (2MWT) and Timed Up-and-Go test (TUG) results between UKA and TKA for isolated medial knee osteoarthritis (OA). We hypothesized that UKA yields faster functional recovery than TKA as measured with the 2MWT and TUG.

Methods: 

We conducted a randomized controlled trial comparing medial UKA and TKA in patients with isolated medial knee OA. A total of 110 patients were enrolled; after 11 exclusions, 99 patients (50 UKA, 49 TKA) were included in the final analysis. The patients were tested using the 2MWT and TUG preoperatively and at 6 weeks, 3 and 6 months, and 1 and 2 years postoperatively. Patient-reported outcome measures (PROMs) were also evaluated. The mean 2MWT, TUG, and PROM results were compared between groups at each time point.

Results: 

The mean 2MWT distance after UKA was significantly longer than that after TKA at 6 weeks (96.5 ± 22.6 m for UKA compared with 81.1 ± 19.1 m for TKA; difference, 18 m [95% confidence interval (CI),10.4 to 25.6 m]; p < 0.001), 3 months (102.1± 24.4 compared with 87.5 ± 22.3 m; difference, 14.7 m [95% CI, 5.4 to 24.0 m]; p = 0.002), and 6 months (102.8 ± 16.2 compared with 89.6 ± 15.3 m; difference, 13.2 m [95% CI, 6.9 to 19.5 m]; p < 0.001). The values at 1 and 2 years were similar after UKA and TKA. The mean TUG after UKA was also significantly shorter than that after TKA at 6 weeks and 3 months. The mean PROMs were similar after both treatments, with the exception of the Oxford Knee Score and subscales of the Knee injury and Osteoarthritis Outcome Score at 6 weeks and 3 months postoperatively.

Conclusions: 

The 2MWT indicated that UKA for isolated medial knee OA enabled faster recovery than TKA did at 6 weeks to 6 months, and earlier recovery was also seen with the TUG at 6 weeks to 3 months. The 2MWT and TUG results after UKA and TKA were similar to one another at 1 and 2 years.

Level of Evidence: 

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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单间室和全膝关节置换术功能恢复的比较：一项随机对照试验

背景： 

缺乏使用基于性能的测试对单间室膝关节置换术 (UKA) 和全膝关节置换术 (TKA) 之间的功能恢复进行比较。因此，本研究旨在比较 UKA 和 TKA 对单纯内侧膝骨关节炎 (OA) 的 2 分钟步行试验 (2MWT) 和计时起步试验 (TUG) 结果。我们假设使用 2MWT 和 TUG 测量，UKA 比 TKA 产生更快的功能恢复。

方法： 

我们进行了一项随机对照试验，在孤立性膝关节内侧 OA 患者中比较内侧 UKA 和 TKA。共有 110 名患者入组；在 11 次排除后，99 名患者（50 名 UKA，49 名 TKA）被纳入最终分析。患者在术前和术后 6 周、3 个月和 6 个月以及 1 年和 2 年时使用 2MWT 和 TUG 进行了测试。还对患者报告的结果测量 (PROM) 进行了评估。在每个时间点比较组间的平均 2MWT、TUG 和 PROM 结果。

结果： 

6 周时，UKA 后平均 2MWT 距离明显长于 TKA 后（UKA 为 96.5 ± 22.6 m，TKA 为 81.1 ± 19.1 m；差异为 18 m [95% 置信区间 (CI)，10.4 至 25.6 m] ；p < 0.001），3 个月（102.1± 24.4 与 87.5 ± 22.3 m；差异，14.7 m [95% CI，5.4 至 24.0 m]；p = 0.002）和 6 个月（102.8 ± 16.2 与 89.6 ± 15.3 m；差异，13.2 m [95% CI，6.9 至 19.5 m]；p < 0.001）。UKA 和 TKA 后 1 年和 2 年的值相似。在 6 周和 3 个月时，UKA 后的平均 TUG 也明显短于 TKA 后。两种治疗后的平均 PROM 相似，除了牛津膝关节评分和膝关节损伤分量表以及术后 6 周和 3 个月的骨关节炎结果评分。

结论： 

2MWT 表明，UKA 治疗孤立性膝关节内侧 OA 在 6 周到 6 个月时比 TKA 恢复得更快，并且在 6 周到 3 个月时 TUG 也可以看到更早的恢复。UKA 和 TKA 后 1 年和 2 年的 2MWT 和 TUG 结果相似。

证据等级： 

治疗级别 I。有关证据级别的完整描述，请参阅作者说明。