Mobile-Bearing Knee Arthroplasty Shows Strong Functional Gains in Elderly Indian Patients: Study

As the global prevalence of osteoarthritis (OA) continues to rise, reaching an estimated 595 million people in 2020, there is an urgent need for surgical interventions that accommodate the diminished physiological reserves of the elderly, especially in India, where those aged 75 and older have already exceeded the national life expectancy. While traditional Total Knee Arthroplasty (TKA) often leads to extended hospital stays and higher readmission rates in geriatric populations, Dr. Yashpal Gulati and colleagues from a tertiary care center aimed to evaluate if the bone-sparing MB-UKA could fill this clinical gap by providing a safer, effective alternative for isolated medial compartment degeneration.

Therefore, the retrospective review analyzed 32 primary medial MB-UKA procedures performed on 23 patients with a mean age of 76.9 years between 2018 and 2023. To ensure surgical success, the study utilized strict inclusion criteria, including Kellgren-Lawrence grade IV medial OA, varus deformity under 10°, and stable ligaments, while excluding those with lateral cartilage damage. The primary endpoints were measured through the American Knee Society Score—Functional subscale (AKSS-F) and the Forgotten Joint Score-12 (FJS-12) over a three-year follow-up period, with statistical significance established via paired t-tests.

Key Clinical Findings of the Review Includes:

• Significant Functional Surge: The study reported that AKSS-F scores climbed consistently from a preoperative average of 47.8 to 77.1 at the three-year mark.

• Superior Patient Satisfaction: The study noted a high FJS-12 score of 87.8, indicating that patients often forgot their prosthetic joint during daily activities, reflecting a "natural" knee feel.

• Exceptional Safety Profile: Remarkably, the study found no incidences of deep vein thrombosis (DVT), periprosthetic infection, component loosening, or mortality within the cohort.

• Resilience Against Comorbidities: Despite 60.9% of the patients suffering from hypertension and 30.4% from diabetes, the study observed that these underlying health issues did not compromise the excellent midterm results.

The results suggest that MB-UKA delivers robust and durable functional improvements and high satisfaction levels in multimorbid, carefully selected elderly Indian cohorts, as evidenced by the significant net gains in postoperative scoring.

Thus, the review concludes clinicians may consider this tissue-sparing technique as a primary surgical option for elderly patients with isolated medial compartment disease to mitigate the risks of functional decline and dependency often associated with more invasive arthroplasty.

The findings are limited by the small sample size and the retrospective nature of the study, highlighting a need for larger, prospective multi-center trials to confirm these promising results over a longer duration.

Reference

Gulati Y, Vaishya R, Singla R, Bahl V, Vaish A. Mobile-bearing UKA in elderly (≥75 Years) Indian cohorts: Excellent mid-term function and satisfaction despite comorbidities. Journal of Orthopaedics. 2026.