Quicker Return to Work After Unicompartmental vs Total Knee Arthroplasty

Overview

This study demonstrates that patients undergoing unicompartmental knee arthroplasty (UKA) return to work sooner and report better work-related function and satisfaction compared to those receiving total knee arthroplasty (TKA). UKA patients also experience fewer intraoperative complications and maintain more natural knee biomechanics, contributing to improved postoperative outcomes.

Background

Knee arthroplasty is an effective treatment for osteoarthritis-related knee pain, with TKA being the most common procedure. However, a significant proportion of TKA patients do not return to work or report impaired work ability postoperatively. UKA, introduced in the 1970s, is a less invasive alternative that preserves knee biomechanics and has been associated with better range of motion and fewer complications. Given the rising number of knee arthroplasties in working-age populations, understanding the impact of UKA versus TKA on return to work is clinically important.

Data Highlights

The study included UKA patients who underwent primary Oxford UKA between 2003 and 2012 with at least 2 years follow-up, compared to a similar cohort of TKA patients from the same centers and period. Data collected included return to work timing, work ability scores (WORQ), workability, and satisfaction. Baseline characteristics such as age, sex, BMI, diabetes status, smoking, and ASA classification were recorded. The UKA group showed faster return to work and better functional outcomes than the TKA group.

Key Findings

• UKA patients returned to work sooner postoperatively compared to TKA patients.
• UKA preserves natural knee biomechanics by maintaining the anterior cruciate ligament, unlike TKA.
• UKA patients reported better WORQ function scores, indicating improved work-related knee function.
• Workability and satisfaction regarding ability to work were higher in UKA patients than in TKA patients.
• UKA is associated with fewer intraoperative complications such as blood transfusion, stroke, thromboembolism, and myocardial infarction.
• UKA patients demonstrated better range of motion, especially in those under 65 years of age.

Clinical Implications

Clinicians should consider UKA as a viable option for patients with anteromedial osteoarthritis and intact ligaments who are of working age, as it may facilitate a quicker return to employment and better postoperative work function. This can improve patient quality of life and reduce societal productivity loss. Shared decision-making should incorporate these functional and occupational outcomes when selecting the type of knee arthroplasty.

Conclusion

UKA offers significant advantages over TKA in terms of faster return to work, better work-related knee function, and higher patient satisfaction. These findings support the use of UKA in appropriate patients to optimize postoperative recovery and work participation.

References

1. Author/Source/Year -- Patients Experience Quicker Return to Employment Following Unicompartmental Knee Arthroplasty Compared to Total Knee Arthroplasty