SPORTS MEDI CI NE

Participation in sporting activities following knee replacement:

total versus unicompartmental
Graeme Philip Hopper William Joseph Leach
Received: 24 April 2008 / Accepted: 12 July 2008 / Published online: 12 August 2008
Springer-Verlag 2008
Abstract Few studies have been published assessing
patients sporting activity after total knee arthroplasty
(TKA) and unicompartmental knee arthroplasty (UKA).
Common concerns of patients undergoing TKA or UKA are
whether they can continue with sporting activities after
surgery. This study compares the sporting activity of TKA
and UKA patients preoperatively and postoperatively. A
total of 110 patients were surveyed by questionnaire. Sev-
enty-six patients had undergone TKA and 34 patients had
undergone UKA. They were assessed for their participation
in low-impact sport preoperatively and postoperatively at a
mean follow up of 21.6 5.3 and 22.3 7.8 months,
respectively. Low-impact sports are those which a surgeon
would expect patients to be able to participate in postop-
eratively. Data were separately analysed for older and
younger patients and women and men, respectively. The
results were as follows: before surgery, 55 of 76 patients in
the TKA group participated in an average of 1.3 different
sports and postoperatively, 35 of 76 patients participated in
an average of 0.7 different sports. In the UKA group, 30 of
34 patients participated in an average of 1.5 different sports
preoperatively and postoperatively, 29 of 34 patients par-
ticipated in an average of 1.4 different sports. The return to
sport rate was 96.7% in the UKA group and 63.6% in the
TKA group. In the TKA group, the average frequency of
sport preoperatively was 3.0 sessions per week (62.7 min)
and postoperatively it decreased to 2.0 sessions per week
(37.5 minutes). In the UKA group, the average frequency of
sport preoperatively was 3.2 sessions per week (85.0 min)
and postoperatively it increased to 3.4 sessions per week
(92.1 min). The average time before resuming sport after
surgery was 4.1 months in the TKA group and 3.6 months
in the UKA group; 42.9% of patients in the TKA group and
24.1% of patients in the UKA group reported pain during
sports after surgery; 80.3% of the patients in the TKA group
and 88.2% of the patients in the UKA group felt that surgery
had increased or maintained their sporting ability. Oxford
knee scores decreased signicantly one year after surgery in
both the TKA group and the UKA group. In conclusion, the
patients in our study had a signicantly greater return to
sport rate after UKA than patients who had undergone
TKA. A large proportion of patients in the TKA group did
not return to sport which their surgeon would have expected
them to including golf and bowls. Patients in the UKA
group also took part in more sporting sessions and for a
longer period of time than patients in the TKA group.
Moreover, patients undergoing UKA also returned to sport
more quickly than patients undergoing TKA.
Keywords Knee Arthroplasty Replacement
Sports Questionnaires
Introduction
Knee replacement surgery replaces a damaged, worn or
diseased knee joint with an articial one. Total knee
arthroplasty (TKA) replaces both tibiofemoral surfaces.
Unicompartmental knee arthroplasty (UKA) replaces the
medial or lateral tibiofemoral surface.
Few studies have been published assessing patients
return to sporting activity after TKA and UKA. This study
G. P. Hopper (&)
University of Glasgow, University Avenue,
Glasgow G12 8QQ, UK
e-mail: hopperg@doctors.org.uk
W. J. Leach
Department of Orthopaedics, Western Inrmary,
Dumbarton Road, Glasgow G11 6NT, UK
1 3
Knee Surg Sports Traumatol Arthrosc (2008) 16:973979
DOI 10.1007/s00167-008-0596-9
analyses and compares the sporting activity of TKA and
UKA patients preoperatively and postoperatively with a
minimum 12-month follow up.
Materials and methods
Study design
Between January 2004 and September 2006, 141 TKAs
(TKA group) and 41 UKAs (UKA group) were performed
by two senior surgeons. Both surgeons used the same
standardised surgical technique for both TKA and UKA.
The TKAs were carried out using a total condylar design,
the majority of which were PFC (DePuy,Warsaw, Indiana).
All UKAs were carried out using the Oxford designed
implant.
Patients over the age of 75, those who had received
additional surgery to the lower limb and patients with
bilateral procedures were excluded from the study.
Excluded from the TKA group were 49 patients over the
age of 75, 5 patients who had received additional lower
limb surgery and 3 patients with bilateral TKA, leaving 84
patients in this group. Excluded from the UKA group were
4 patients over the age of 75 which left 37 patients in this
group. Overall, 121 patients were contacted by postal
questionnaire.
Eighty-one patients returned the questionnaire (66.9%).
In the TKA group, 55 of the 84 patients returned the
questionnaire (65.5%) and in the UKA group, 26 of the 37
patients returned the questionnaire (70.3%). No reminder
questionnaires were sent out. However, of the 40 patients
who did not return the questionnaire, we were able to
contact 29 by telephone to ask them about their partici-
pation in sport before and after surgery. Therefore, the
study contained 76 of the 84 TKA patients (90.1%) and 34
of the 37 UKA patients (91.9%). For data analysis, both
groups were divided into male and female patients as well
as younger and older patients. The age categories were
formed by taking those above and below the median for
each group.
Questionnaire
The questionnaire ascertained the patients participation in
ve different sports before and after surgery: golf, swim-
ming, dancing (line/ballroom), bowls and cycling. These
are low-impact sports which a surgeon would expect
patients to return to following their knee replacement [7].
The questionnaire also ascertained the number of
sporting sessions the patients would participate in over a
week and the average length of a session. For analytical
purposes, ranges were provided for the average session
length (030, 3060, 6090, 90120, [120 mins). Patients
were also asked how soon they returned to sporting activity
after their knee operation. Ranges were again provided for
statistical analysis (03, 36, 69, 912, [12 months). For
analytical purposes, the minimum session length and the
minimum time resuming sport would be used when anal-
ysing the results.
The patients were also asked whether their knee felt
stable or unstable during sport and if it felt painful during
sport. Finally, the questionnaire asked for the patients
overall satisfaction with their knee replacement with
regards to increasing/maintaining their sporting ability and
reasons for any reduction in sporting activity.
Clinical outcome
Patients were followed up at 3 and 12 months after surgery
and every 12 months thereafter. The clinical outcome was
assessed using the Oxford Knee Score; the patients knee
range of motion was measured with a goniometer and
compared to previous results.
Data analysis
Data was primarily analysed by descriptive statistics. Statisti-
cal analysis was performed using Microsoft Excel software
(2003, 11.5612.5606) with chi-squared tests and t-tests. The
level of statistical signicance was set at P\0.05.
Results
Demographics
The mean age of the 76 patients in the TKA group at surgery
was 62.1 8.9 years (range, 3575). The mean age at the
time of the study was 63.7 8.8 years (range, 3776). The
average length of time between surgery and the study was
21.6 5.3 months (range, 1342). A total of 32 TKAs
were performed on the left knee and 44 on the right knee; 32
patients were male (42.1%) and 44 were female (57.9%).
The mean age of the male group at surgery was
62.1 10.1 years (range, 3575) and the female group was
62.0 7.9 years (range, 4074). The younger group (\63)
consisted of 37 patients and the older group (C63) consisted
of 39 patients. The mean age of the younger group at sur-
gery was 54.7 6.7 years (range, 3562) and the older
group was 69.0 3.1 years (range 6375).
The mean age of the 34 patients in the UKA group at
surgery was 61.3 9.0 years (range, 4375). The mean
age at the time of the study was 62.9 8.9 years (range,
4678). The average length of time between surgery and
the study was 22.3 7.8 months (range, 1244). A total of
974 Knee Surg Sports Traumatol Arthrosc (2008) 16:973979
1 3
16 UKAs were performed on the left knee and 18 on the
right knee. Twenty patients were male (58.8%) and 14
were female (41.2%). The mean age of the male group at
surgery was 61.1 8.4 years (range, 4975) and the
female group was 61.6 10.2 years (range, 4375). The
younger group (\61) and the older group (C61) both
consisted of 17 patients. The mean age of the younger
group at surgery was 53.5 4.4 years (range, 4360) and
the older group was 79.1 4.4 years (range 6275).
Sports disciplines and participation
In the TKA group, 55 of 76 patients (72.4%) participated in
low-impact sport before surgery and 35 of 76 patients
(46.1%) participated in low-impact sport after surgery.
Therefore, 63.6% of the patients returned to sport in the
TKA group after surgery. This reduction in the number of
patients participating in low-impact sport was highly sta-
tistically signicant (P = 0.003). Male patients showed a
greater rate of return to sport than females in the TKA
group (76.0 vs. 56.7%) but there was very little difference
in the age categories.
In the UKA group, 30 of 34 patients (88.2%) partici-
pated in low-impact sport before surgery and 29 of the 34
patients (85.3%) participated in low-impact sport after
surgery. Therefore, 96.7% of the patients participating in
sports preoperatively returned to participating postopera-
tively in the UKA group. There were no age or gender
related differences in the UKA group. Overall, a signi-
cantly greater number of patients returned to low-impact
sport in the UKA group compared to the TKA group
(P = 0.031).
In the TKA group, patients took part in an average of 1.3
different low-impact sports preoperatively and in 0.7 dif-
ferent low-impact sports at the time of the questionnaire.
This was a highly signicant reduction in the number of
sports which patients participated in following surgery
(P\0.001). The number of sports patients played preop-
eratively and postoperatively in the TKA group is outlined
in Table 1.
In the UKA group, patients took part in an average of
1.5 different low-impact sports preoperatively and 1.4
different low-impact sports at the time of the questionnaire
(P = 0.083). The number of sports patients participated in
preoperatively and postoperatively in the UKA group is
outlined in Table 2.
The individual sports which the TKA and UKA patients
participated in are shown in Table 3 and 4 respectively.
In the TKA group, there was a highly signicant
reduction in the number of patients playing bowls and golf
postoperatively (P\0.001). There was also a signicant
reduction in the number of patients dancing, swimming and
Table 1 Number of sports carried out by the patients in the TKA
group preoperatively and postoperatively. The number of patients
playing more than 1 sport decreased postoperatively
Number of sports % of patients
participating
before surgery
% of patients
participating
after surgery
0 27.6 52.6
1 38.2 27.6
2 19.7 17.1
[2 14.5 2.7
Table 2 Number of sports carried out by the patients in the UKA
group preoperatively and postoperatively. There was very little
change postoperatively
Number of sports % of patients
participating
before surgery
% of patients
participating
after surgery
0 11.8 14.7
1 41.2 41.2
2 38.2 35.3
[2 8.8 8.8
Table 3 Individual sports carried out by the patients in the TKA
group preoperatively and postoperatively. Swimming was the most
popular sport before and after surgery. Patients signicantly
decreased their participation in all sports after surgery
Individual
sport
Number of
patients
participating
before
surgery
Number of
patients
participating
after surgery
Difference
(%)
Swimming 30 23 -23.3
Bowls 17 7 -58.8
Golf 17 5 -70.6
Dancing 16 11 -31.2
Cycling 15 7 -53.3
Table 4 Individual sports carried out by the patients in the UKA
group preoperatively and postoperatively. Bowls, golf and swimming
were the most popular sports. There was very little change in sports
participation following surgery
Individual
sport
Number of patients
participating before
surgery
Number of patients
participating after
surgery
Difference
(%)
Bowls 14 11 -21.4
Golf 13 13 0.0
Swimming 12 9 -25.0
Cycling 6 5 -17.0
Dancing 5 5 0.0
Knee Surg Sports Traumatol Arthrosc (2008) 16:973979 975
1 3
cycling (P = 0.043, 0.011 and 0.002, respectively). This
shows that a return to low-impact sport postoperatively
may not occur following TKA even though it is considered
likely by the surgeon (Fig. 1).
On the other hand, there was very little change in sports
participation in the UKA group postoperatively (Fig. 2).
Participation in swimming, bowls and cycling did
decrease postoperatively but these were not signicant
changes. Eleven of fourteen bowlers (78.65%) returned to
their sport postoperatively which contrasts to the TKA
group where only 7 of 17 bowlers (41.2%) returned. Fur-
thermore, 100% of golfers (13 of 13) returned to playing
golf postoperatively in the UKA group which greatly
contrasts to the TKA group where golf showed a very
signicant decrease in participation (30% return rate).
In the TKA group, the average time for returning to
sporting activity was 4.1 months. Twenty-ve percent of
the patients returned to sport within the rst 3 months after
surgery and 61.1% had returned within 6 months. The
remaining 38.9% resumed sport more than 6 months after
surgery. Female patients (4.8 months) returned to sporting
activity later than male patients (4.0 months) following
surgery (P = 0.160). Patients in the older group returned to
sport quicker than those in the younger group (4.2 months
and 4.5 months, respectively) although this was not sig-
nicant (P = 0.785).
In the UKA group, the average time for returning to
sport was 3.6 months. Exactly 44.8% of the patients
returned to sport within the rst 3 months after surgery and
69.0% had returned within 6 months. The remaining 21.0%
of the patients took longer than 6 months to return to
sporting activity. There were no gender related differences
but younger patients (2.5 months) were found to return to
sport quicker than older patients (4.4 months) following
surgery. Overall, it can be said that the time to return to
sport following unicompartmental knee replacement is
quicker than it is following total knee replacement.
Sports frequency and session length
In the TKA group, the average frequency of sport preop-
eratively was 3.0 sessions per week and postoperatively it
decreased to 2.0 sessions per week. This difference was
highly signicant (P\0.001). There were no age or gen-
der related differences.
In the UKA group, the average frequency of sport pre-
operatively was 3.2 sessions per week and postoperatively
it increased to 3.4 sessions per week. However, this
increase was not statistically signicant (P = 0.727). There
were no age or gender related differences. Therefore, it can
be said that there is a signicant difference in sports fre-
quency when comparing the TKA and UKA groups
(Fig. 3).
In the TKA group, the minimum session length was
62.7 min before surgery and 37.5 min after surgery. In the
UKA group, the minimum session length was 85.0 min
before surgery and 92.1 min after surgery. The decrease in
session length in the TKA group was highly signicant
(P\0.001) and the small increase in the UKA group was
not signicant (P = 0.487). There were no gender related
Sporting Disciplines - TKA
0
5
10
15
20
25
30
35
Swimming
Sport
N
u
m
b
e
r

o
f

p
a
t
i
e
n
t
s
Preoperatively
Postoperatively
Cycling Dancing Golf Bowls
Fig. 1 Different sporting activities each patient was active in before
and after TKA. All sports have decreased in participation postoper-
atively with highly signicant changes in golf and bowls
Sporting Disciplines - UKA
0
2
4
6
8
10
12
14
16
Bowls
Sport
N
u
m
b
e
r

o
f

p
a
t
i
e
n
t
s
Preoperatively
Postoperatively
Dancing Cycling Swimming Golf
Fig. 2 Different sporting activities each patient was active in before
and after UKA. There are no signicant changes in activity
postoperatively
Sports Frequency - TKA v UKA
0
0.5
1
1.5
2
2.5
3
3.5
4
TKA
Group
A
v
e
r
a
g
e

N
u
m
b
e
r

o
f

S
p
o
r
t
i
n
g

S
e
s
s
i
o
n
s
Preoperatively
Postoperatively
UKA
Fig. 3 Average number of sessions of sport preoperatively and
postoperatively in the TKA and UKA groups. There is a signicantly
greater number of sporting sessions postoperatively in the UKA group
in comparison to the TKA group. There is also a decrease in sessions
in the TKA group whereas there is an increase in sessions in the UKA
group postoperatively
976 Knee Surg Sports Traumatol Arthrosc (2008) 16:973979
1 3
or age related differences in the TKA group and the UKA
group. Therefore, comparing the TKA and UKA groups
shows a substantial difference in the minimum session
length postoperatively compared to preoperatively (Fig. 4).
Sense of well-being during sport
In the TKA group, 15 of the 35 patients (42.9%) who
returned to sport reported pain during sport. Nine of the
fteen patients reported pain in the replaced joint and 6 out
of the 15 patients reported pain elsewhere. Six of the nine
patients who reported pain in the replaced joint were young
female patients. Nine of the thirty-ve patients (25.7%)
who returned to sport also felt that their replaced knee was
unstable whilst they were playing sport. There were no age
or gender related differences in the stability of the knee
during sport.
In the UKA group, 7 of the 29 patients (24.1%) who
returned to sport reported pain during sport. Of the 7
patients reporting pain, 4 patients had pain in the replaced
joint and 3 patients had pain in other regions. The 4 patients
who had pain in the replaced joint were young female
patients, which is similar to the results of the TKA group.
All of the 29 patients felt their knee was stable during sport.
In the TKA group, 25 of the 55 patients (45.5%) who
participated in sport preoperatively had to reduce their
sporting activity following their knee replacement. In the
UKA group, 8 of the 30 patients (26.7%) who participated
in sport preoperatively reduced their sporting activity fol-
lowing their knee replacement. The reasons for these
patients reducing their sporting activity postoperatively are
shown in Table 5 below.
Overall satisfaction of the operation in both groups with
regards to increasing/maintaining their sporting ability is
shown in Fig. 5 below.
The majority of patients who underwent knee replace-
ment surgery were very satised with their sporting ability
following surgery. Exactly 80.3% of the patients in the
TKA group and 88.2% of the patients in the UKA group
were either very satised or satised with their surgery.
Therefore there was slightly better satisfaction with the
UKA group compared to the TKA group but this was not a
signicant difference (P = 0.176).
Clinical outcome
In the TKA group, the Oxford knee score improved sig-
nicantly from 39.6 preoperatively to 21.6 one year after
surgery (P\0.001). In the UKA group, the Oxford knee
score also improved signicantly from 39.4 preoperatively
to 17.9 one year after surgery (P\0.001). There was
greater improvement in the UKA group than the TKA group
but this was not a signicant change (P = 0.435) (Fig. 6).
Session Length (TKA v UKA)
0
10
20
30
40
50
60
70
80
90
100
TKA UKA
Group
A
v
e
r
a
g
e

S
e
s
s
i
o
n

L
e
n
g
t
h

(
M
i
n
s
)
Preoperatively
Postoperatively
Fig. 4 Average minimum session length preoperatively and postop-
eratively in the TKA and UKA groups. There is a signicantly greater
session length postoperatively in the UKA group in comparison to the
TKA group. There is also a decrease in length in the TKA group
whereas there is an increase in length in the UKA group
postoperatively
Table 5 Patient reasons for a reduction in their sporting activity
postoperatively. The most common reason was as a precaution in
both groups
Reason for sports reduction TKA group
(% of patients)
UKA group
(% of patients)
As a precaution 44.0 62.5
Pain in the replaced joint 40.0 12.5
Pain in other regions 12.0 25.0
Old age 4.0 0.0
Overall Satisfaction (TKA v UKA)
0
10
20
30
40
50
60
70
80
90
Very Satisfied
Satisfaction
P
e
r
c
e
n
t

o
f

P
a
t
i
e
n
t
s

(
%
)
TKA
UKA
Dissatisfied Fairly Satisfied Satisfied
Fig. 5 Patient satisfaction with regards to sporting ability after their
operation. The majority of patients in both groups were very satised
and feel as though they have increased/maintained their sporting
ability. UKA patients show a greater satisfaction than TKA patients
Oxford Knee Scores
0
5
10
15
20
25
30
35
40
45
Pre-operatively 3 months 1 year
Time Taken
S
c
o
r
e
TKA
UKA
Fig. 6 Oxford knee scores for the TKA group and UKA group
preoperatively, 3 months after surgery and 1 year after surgery
Knee Surg Sports Traumatol Arthrosc (2008) 16:973979 977
1 3
The mean preoperative range of motion was 5.7104.1
in the TKA patients and 4.0117.5 in the UKA patients.
One year after surgery the mean range of motion was 1.1
102.7 in the TKA patients and 2.1115.9 in the UKA
patients. There was an improvement in range of motion
postoperatively in both groups, however, there was no
signicant difference between the two groups.
Discussion
Total knee arthroplasty versus unicompartmental
knee arthroplasty
Total knee arthroplasty (TKA) is a procedure that has been
proven for the treatment of advanced osteoarthritis of the
knee [12]. UKA is an established and effective treatment
for osteoarthritis affecting one side of the knee only [10].
UKA is now routinely performed via a minimally invasive
approach which may reduce postoperative morbidity and
increase the speed of recovery [9].
Several studies have been carried out to compare the
results of both TKA and UKA patients. Yang et al. [12]
concluded that patients with UKA have less blood loss,
shorter hospital stay, quicker rehabilitation and greater
post-operative range of motion than patients with TKA.
Moreover, Newmann et al. in a 5 year prospective study
[9] found that patients with UKA give signicantly supe-
rior results compared to patients with TKA with regards to
morbidity, knee movement and length of hospital stay.
With regards to range of motion of the knee, this study
found that TKA and UKA patients had an improvement in
their knee movement but there was no difference between
the groups which contrasts the ndings of Yang et al. and
Newmann et al. A recent study has suggested that TKA is a
more reliable choice than UKA for knee osteoarthritis [1].
Furthermore, Furnes et al. found that survival of UKA
prostheses was not as good as TKA prostheses: 85.2 versus
93.0% at 8 years, P\0.001 [4].
Sports participation
Few studies have been published assessing patients return
to sporting activity after TKA and UKA. This study shows
that the majority of patients who have a TKA or UKA
participate in low-impact sport before they undergo surgery
(72.4 and 88.2%, respectively). Therefore, it is important
that patients can participate in these sports following sur-
gery. In the TKA group, only 63.6% of patients returned to
sport after surgery whereas in the UKA group, 96.7% of
patients returned to sport after surgery. Bradbury et al. [2]
stated that 77% of their TKA patients who had participated
in regular exercise in the year before their surgery returned
to sport following surgery. Studies assessing the return to
sport following UKA have varied from 67 to 94.8% [3, 5,
8, 11] with the results from this study lying slightly greater
than this range.
A number of studies have been carried out to look at
TKA and the return to specic sport. Mallon et al. [6]
looked at the return to sport of active golfers following
surgery. They found that the players handicap increased
signicantly and their driving distance was substantially
reduced. In this study, golf is one of the most popular low-
impact sports in both the TKA group and the UKA group.
Golfers who underwent TKA had a very poor return to the
sport following surgery (29.4%). On the other hand, golfers
who underwent UKA had a 100% return rate to the sport.
Bradbury et al. [2] analysed both high-impact and low-
impact sports and found that patients were more likely to
return to low impact sports such as bowls. However, this
study illustrated that this may not always be the case as
only 7 of 17 bowlers (41.2%) in the TKA group returned to
the sport following surgery. On the other hand, 78.6% of
patients returned to bowls in the UKA group following
surgery. This study also found that patients returned to
sport quicker following UKA compared to TKA (3.6 and
4.1 months, respectively). This contrasts to Walton et al.
[11] who found that UKA patients returned to sporting
activity no sooner than TKA patients.
In our study UKA patients participated in more sporting
sessions than TKA patients preoperatively (3.2 and 3.0,
respectively) and postoperatively (3.4 and 2.0, respec-
tively). The minimum session length for UKA patients was
also longer than that of the TKA patients preoperatively
(85.0 and 62.7, respectively) and postoperatively (92.1 and
37.5 min, respectively). This also illustrates that the num-
ber of sessions and the minimum session length in the
UKA group increased from its preoperative average and
they decreased in the TKA group. However, in a recent
study sporting activity following UKA by Naal et al. [8], it
was found that patients participate in an average of 2.8
sessions of sport postoperatively with a minimum session
length of 55 minutes. These values had decreased from
2.9 sessions at a minimum session length of 66 min pre-
operatively. However, these values were not signicantly
different.
This study found that patient well-being during sport is
better for UKA patients than TKA patients. Exactly 42.9%
of patients in the TKA group reported pain during sport and
25.7% said that they felt their knee was unstable. In the
UKA group, only 24.1% reported pain during sport and no
patients felt their knee was unstable. It was also found that
more patients in the UKA group (88.2%) reported that
surgery had maintained or improved their sporting activity
compared to the TKA group (80.3%). These gures were
comparable with Naal et al. [8] who found that 90.3% of
978 Knee Surg Sports Traumatol Arthrosc (2008) 16:973979
1 3
their patients who underwent UKA had maintained or
improved their sporting activity.
The Oxford Knee Score of the UKA patients was
slightly superior to that of the TKA patients in this study.
The mean score for the UKA patients postoperatively was
17.9 compared to 21.6 of the TKA patients. This was
comparable with Walton et al. [11] who found the mean
Oxford Knee Score to be 22.17 in UKA patients and 24.5
in TKA patients.
Limitations of the study
This study may suffer from several drawbacks. The ques-
tionnaire asked for patients to recall sports they played
before their operation which may have dated back several
years. Another drawback may be the difference in sample
sizes (76 and 34 patients, respectively), although we would
routinely expect more patients to undergo TKA than UKA
in any given time period.
It could also be suggested that the TKA patients will
have more advanced disease than the UKA patients as it is
affecting their whole knee rather than one side. This would
suggest that the UKA patients could take part in more sport
than the TKA patients as a result. However, the Oxford
knee scores were similar before the operation as shown in
Fig. 6 above which suggests that both groups would be
able to take part in similar sports.
Summary
In our study a signicantly greater number of patients
returned to low-impact sport after UKA (96.7%) compared
to TKA (63.6%). Patients who had undergone UKA also
returned to sport more quickly (3.6 months) than patients
who had undergone TKA (4.1 months). Patients in the
TKA group suffered a highly signicant reduction in
patients playing golf and bowls postoperatively and a
signicant reduction in patients swimming, dancing and
cycling postoperatively. This contrasted to the UKA group
where there was very little change in patients participating
in low-impact sport postoperatively. Patients in the UKA
group also participated in a greater number of sporting
sessions with a higher minimum session length as opposed
to the TKA group. Patients in the TKA group reported
more pain during sport in comparison to those in the UKA
group (42.9 vs. 24.1%) and several TKA patients also felt
their knee was unstable during sport. More patients
reported that they maintained or increased their sporting
activity postoperatively in the UKA group (88.2%) com-
pared to the TKA group (80.3%).
Acknowledgments With grateful thanks to: all patients who
showed their support by completing the questionnaire; Heather Scott
and Deborah McGilveray for their contribution to this work.
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