Jacob Fyhring Mortensen, Paul Blanche, Claes Sjørslev Blom, Morten Vase, Søren Overgaard, Andreas Kappel, Martin Lindberg-Larsen, Frank Madsen, Snorre Læssøe Stephensen, Henrik Morville Schrøder, Lasse Enkebølle Rasmussen, Per Wagner Kristensen, Svend Erik Østgaard, Anders Odgaard
Background: The superiority of medial unicompartmental knee arthroplasty (mUKA) versus total knee arthroplasty (TKA) for isolated anteromedial knee osteoarthritis (AMOA) remains a subject of ongoing debate. We present the 2-year results of a multicenter, randomized trial comparing the patient-reported and clinical outcomes of these 2 implant types in the treatment of AMOA.
Methods: This double-blinded superiority trial recruited patients with severe AMOA at 10 arthroplasty centers and randomized them to undergo either mUKA or TKA. The primary outcome was the average improvement in the Oxford Knee Score (OKS) over 2 years, analyzed by intention-to-treat. A range of patient-reported outcomes served as secondary outcomes. Death, revision, and other reoperations were analyzed as serious adverse events (SAEs).
Results: Between September 2017 and March 2021, 350 patients were randomized: 177 (79 female, 98 male; mean age, 67.7 ± 7.5 years) to mUKA and 173 (84 female, 89 male; mean age, 66.7 ± 7.8 years) to TKA. The average 2-year OKS improvement differed by 3.5 points (95% CI, 2.3 to 4.7; p < 0.001) in favor of mUKA, although this difference was below the generally accepted minimal clinically important difference (MCID) of 4 to 5 points. Ten of the 12 secondary outcomes favored mUKA, while the remaining 2 were nonsignificant. The differences in the Forgotten Joint Score (FJS) (14.1; 95% CI, 9.5 to 18.6), range of motion during the first 2 years (7.0°; 95% CI, 5.3° to 8.7°) and at 2 years (5.5°; 95% CI, 3.6° to 7.4°), Knee injury and Osteoarthritis Outcome Score (KOOS) symptoms score (10.3; 95% CI, 7.8 to 12.8), and Short Form-36 (SF-36) bodily pain score (7.6; 95% CI, 4.1 to 11.1) all favored mUKA and reached the MCID. Non-revision reoperations were performed in 4 patients (2.3%) after mUKA and in 12 patients (6.9%) after TKA (9 of the 12 underwent manipulation under anesthesia); the difference was 4.7% (95% CI, 0.2% to 9.8%). There were no differences in the rates of revision or death between the groups.
Conclusions: Averaged over the 2-year follow-up, mUKA demonstrated minor advantages that did not achieve clear clinical superiority on the basis of the OKS difference. However, the FJS, range of motion, KOOS symptoms score, and SF-36 bodily pain score all demonstrated differences in favor of mUKA that were clinically meaningful. The overall findings suggest that mUKA and TKA yield similarly favorable short-term results, with small advantages for mUKA.
Level of evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
{"title":"Medial Unicompartmental Versus Total Knee Arthroplasty in the Treatment of Isolated Anteromedial Knee Osteoarthritis: Two-Year Results from a Double-Blinded, Multicenter, Randomized Trial of 350 Patients.","authors":"Jacob Fyhring Mortensen, Paul Blanche, Claes Sjørslev Blom, Morten Vase, Søren Overgaard, Andreas Kappel, Martin Lindberg-Larsen, Frank Madsen, Snorre Læssøe Stephensen, Henrik Morville Schrøder, Lasse Enkebølle Rasmussen, Per Wagner Kristensen, Svend Erik Østgaard, Anders Odgaard","doi":"10.2106/JBJS.25.00612","DOIUrl":"https://doi.org/10.2106/JBJS.25.00612","url":null,"abstract":"<p><strong>Background: </strong>The superiority of medial unicompartmental knee arthroplasty (mUKA) versus total knee arthroplasty (TKA) for isolated anteromedial knee osteoarthritis (AMOA) remains a subject of ongoing debate. We present the 2-year results of a multicenter, randomized trial comparing the patient-reported and clinical outcomes of these 2 implant types in the treatment of AMOA.</p><p><strong>Methods: </strong>This double-blinded superiority trial recruited patients with severe AMOA at 10 arthroplasty centers and randomized them to undergo either mUKA or TKA. The primary outcome was the average improvement in the Oxford Knee Score (OKS) over 2 years, analyzed by intention-to-treat. A range of patient-reported outcomes served as secondary outcomes. Death, revision, and other reoperations were analyzed as serious adverse events (SAEs).</p><p><strong>Results: </strong>Between September 2017 and March 2021, 350 patients were randomized: 177 (79 female, 98 male; mean age, 67.7 ± 7.5 years) to mUKA and 173 (84 female, 89 male; mean age, 66.7 ± 7.8 years) to TKA. The average 2-year OKS improvement differed by 3.5 points (95% CI, 2.3 to 4.7; p < 0.001) in favor of mUKA, although this difference was below the generally accepted minimal clinically important difference (MCID) of 4 to 5 points. Ten of the 12 secondary outcomes favored mUKA, while the remaining 2 were nonsignificant. The differences in the Forgotten Joint Score (FJS) (14.1; 95% CI, 9.5 to 18.6), range of motion during the first 2 years (7.0°; 95% CI, 5.3° to 8.7°) and at 2 years (5.5°; 95% CI, 3.6° to 7.4°), Knee injury and Osteoarthritis Outcome Score (KOOS) symptoms score (10.3; 95% CI, 7.8 to 12.8), and Short Form-36 (SF-36) bodily pain score (7.6; 95% CI, 4.1 to 11.1) all favored mUKA and reached the MCID. Non-revision reoperations were performed in 4 patients (2.3%) after mUKA and in 12 patients (6.9%) after TKA (9 of the 12 underwent manipulation under anesthesia); the difference was 4.7% (95% CI, 0.2% to 9.8%). There were no differences in the rates of revision or death between the groups.</p><p><strong>Conclusions: </strong>Averaged over the 2-year follow-up, mUKA demonstrated minor advantages that did not achieve clear clinical superiority on the basis of the OKS difference. However, the FJS, range of motion, KOOS symptoms score, and SF-36 bodily pain score all demonstrated differences in favor of mUKA that were clinically meaningful. The overall findings suggest that mUKA and TKA yield similarly favorable short-term results, with small advantages for mUKA.</p><p><strong>Level of evidence: </strong>Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Another Defining Number in Knee Pathology Assessment: Commentary on an article by Miho J. Tanaka, MD, PhD, et al.: \"The Ultrasound-Assisted Patellar Glide Test: A Novel Examination Method for Quantifying Patellar Instability\".","authors":"Peter T Myers","doi":"10.2106/JBJS.25.01164","DOIUrl":"https://doi.org/10.2106/JBJS.25.01164","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"160-161"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tourniquet or No Tourniquet: What Is the Price to Pay in Primary TKA?: Commentary on article by Fu-Li Peng, PhD, et al.: \"Effect of Tourniquet Use on 3D Cement Penetration and Mid-Term Implant Stability in Primary Total Knee Arthroplasty. A Randomized Controlled Trial\".","authors":"Geoffrey F Dervin","doi":"10.2106/JBJS.25.01322","DOIUrl":"https://doi.org/10.2106/JBJS.25.01322","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"154-155"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.25.00480
Andrew B Harris, Jonathan M Vigdorchik, Harpal S Khanuja, Vishal Hegde
{"title":"Erratum: Modern Alignment Strategies in Total Knee Arthroplasty and How to Best Achieve Them.","authors":"Andrew B Harris, Jonathan M Vigdorchik, Harpal S Khanuja, Vishal Hegde","doi":"10.2106/JBJS.ER.25.00480","DOIUrl":"https://doi.org/10.2106/JBJS.ER.25.00480","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e3"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-12-29DOI: 10.2106/JBJS.25.01303
Christina K Hardesty, Anne M Dumaine, Jason G Ina, William Z Morris
{"title":"What's New in Pediatric Orthopaedics.","authors":"Christina K Hardesty, Anne M Dumaine, Jason G Ina, William Z Morris","doi":"10.2106/JBJS.25.01303","DOIUrl":"10.2106/JBJS.25.01303","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"164-170"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-17DOI: 10.2106/JBJS.25.00659
Nathan N O'Hara, Gerard P Slobogean, Robert V O'Toole
{"title":"Evaluating Orthopaedic Research Funding Like a Venture Capitalist.","authors":"Nathan N O'Hara, Gerard P Slobogean, Robert V O'Toole","doi":"10.2106/JBJS.25.00659","DOIUrl":"10.2106/JBJS.25.00659","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"173-175"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-18DOI: 10.2106/JBJS.25.00608
Nathaniel P Disser
{"title":"What's Important: First Things First in Medical Student Research.","authors":"Nathaniel P Disser","doi":"10.2106/JBJS.25.00608","DOIUrl":"https://doi.org/10.2106/JBJS.25.00608","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"171-172"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04Epub Date: 2025-11-13DOI: 10.2106/JBJS.25.00487
Harjot Uppal
{"title":"The Weight of the Lead Apron.","authors":"Harjot Uppal","doi":"10.2106/JBJS.25.00487","DOIUrl":"10.2106/JBJS.25.00487","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":"180"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.24.01169
Michael P Murphy, Kaden M Kunz, Patrick Mark, Jacob Tadje, Madeline Tiee, Bailey Johnson, Hobie Summers, Joseph Cohen, William D Lack
{"title":"Erratum: A Multicenter Study of Intertrochanteric and Pertrochanteric Fragility Fractures: Spanning Fixation Mitigates the Risk of Peri-Implant Fractures.","authors":"Michael P Murphy, Kaden M Kunz, Patrick Mark, Jacob Tadje, Madeline Tiee, Bailey Johnson, Hobie Summers, Joseph Cohen, William D Lack","doi":"10.2106/JBJS.ER.24.01169","DOIUrl":"https://doi.org/10.2106/JBJS.ER.24.01169","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e5"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.2106/JBJS.ER.24.01060
Christiaan H Righolt, Maxwell Luke Armstrong, Thomas R Turgeon, Eric R Bohm, Jhase Sniderman
{"title":"Erratum: Primary Total Knee Arthroplasty in Patients with BMI of ≥50 kg/m2.","authors":"Christiaan H Righolt, Maxwell Luke Armstrong, Thomas R Turgeon, Eric R Bohm, Jhase Sniderman","doi":"10.2106/JBJS.ER.24.01060","DOIUrl":"https://doi.org/10.2106/JBJS.ER.24.01060","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":"108 3","pages":"e2"},"PeriodicalIF":4.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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