“What can i do after my UKA?”
This is a very common question I’m asked by patients who are considering any joint replacement. In reality it’s a very difficult question to answer, as it depends on many different factors, including your age, overall health, and the extent of your condition. There’s no absolute way to predict how much activity patients will get back to after unicompartmental knee replacement, and we will only truly know after the fact.
But let’s say you’re an otherwise healthy, relatively young and fit individual with arthritis of the knee and you’re considering a procedure known as UKA. How long (theoretically) would it be until you were back to activity and what activity can you do? Let’s take a look.
What is UKA?
As an active person, you are, unfortunately, more vulnerable to osteoarthritis of the knee. While sport keeps you fit, strong and healthy in numerous ways, prolonged, vigorous exercise can harm your joints. Some people develop degeneration of their joints, and knees are often the first to show signs of strain.
If you have arthritis that is limited to just one of the three compartments of your knee, you may benefit from an unicompartmental knee arthroplasty (UKA). This is also known as a partial knee replacement.
During the procedure, the portion of your knee affected by arthritis is resurfaced with metal and plastic components. We preserve the healthy cartilage, bone and all the ligaments. It’s often an effective surgical treatment for end-stage arthritis confined to a single compartment of the knee joint.
But how soon is your knee ready to return to sport? What does the available evidence tell us?
Types of evidence
Evidence-based medicine relies on research. But not all research is equal. That’s why we talk about levels of evidence quality. Our goal is to base our recommendations and practice on the highest level of evidence available to us.
A laboratory study based on mice may yield intriguing results but there’s a long way to go before it leads to new treatments for human health. Case studies of a few patients are interesting yet there are too many possible variables for us to believe that the treatments that worked for them would work for most patients.
Randomised controlled trials (RCTs) aim to study a larger group of patients and eliminate as many of variables as possible. Participants are randomly assigned to different groups and either given the treatment being studied or a placebo (sham treatment). In a double-blind trial, neither the patients nor the researchers know who is getting which treatment, which helps to avoid bias.
Often we’ll have several RCTs on the same topic but they’ll all be slightly different in their study design or participants. A meta-analysis can then combine the results of these independent studies and draw out the common themes.
The top level of evidence is a systematic review. This is a critical evaluation of all the research studies on a particular clinical issue. It gives us the best possible answer to the question at hand.
What does the evidence say about returning to sport after UKA?
In March 2022, researchers at University College Hospital, London published a systematic review and meta-analysis of the evidence on returning to sport after UKA. That’s the top level of evidence, as outlined above, meaning we can have considerable confidence in its findings.
They reviewed the results of 11 studies (749 patients) published between 2006 and 2021. Common sporting activities undertaken in all 11 studies were swimming, cycling, walking, soccer, jogging, and downhill skiing.
When it came to returning to sport after UKA,
- 48.1% of patients returned after 3 months
- 76.5% of patients returned after 6 months
- 92.7% of patients returned after 48 months (4 years).
The majority of those who did return to sport did so at a lower level of intensity than before their procedure. There was a slight decline in higher impact sports like soccer and skiing.
If you’re considering UKA, these results should be encouraging. The researchers thought that this relatively rapid return to sport may be possible because UKA is less invasive and less traumatic than its alternative, a total knee replacement. It usually involves less need for pain relief, faster rehab, earlier hospital discharge and faster return to normal walking patterns, all of which moves patients closer to returning to sport.
How can we help?
If you live in Perth or around Broome and enjoy sport but are struggling with your knees, then we’d love to help you.
The first step is to get a referral from your GP, then make an appointment to see me at my rooms in West Perth, Palmyra, Mount Claremont or Broome.
If you’re ready to explore how to improve your knee function, please contact us today.
All information is general and is not intended to be a substitute for professional medical advice. Dr Ross Radic can consult with you to confirm if this procedure is right for you. Any surgical or invasive procedure carries risks. A second opinion may help you decide on the best way forward.