Tesis

Perbandingan Luaran Klinis Artroplasti Lutut Unikompartemental dan Artroplasti Lutut Total untuk Osteoartritis Lutut Terbatas Kompartemen Medial di RSCM dan RSUP Fatmawati = Comparison of Clinical Outcomes Between Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty for Medial Compartment Knee Osteoarthritis at RSCM and RSUP Fatmawati.

Pendahuluan: Artroplasti lutut unikompartemental (UKA) dan total (TKA) merupakan prosedur utama dalam penanganan osteoartritis lutut terbatas pada kompartemen medial. UKA menawarkan keunggulan fungsional yang lebih baik, tetapi seleksi pasien dan pengalaman operator memengaruhi keberhasilannya. Tujuan: Menilai dan membandingkan luaran klinis UKA dan TKA pada pasien osteoartritis lutut medial di RSCM dan RSUP Fatmawati, serta menganalisis pengaruh faktor demografis terhadap pemilihan dan hasil tindakan. Metode: Studi retrospektif terhadap 54 pasien di RSUP Fatmawati dan RSCM. Luaran diukur dengan skor Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), serta angka revisi. Uji ANCOVA digunakan untuk mengontrol variabel usia, indeks massa tubuh (IMT), dan follow-up. Hasil: Skor OKS UKA lebih tinggi dibandingkan TKA secara signifikan (p < 0,001) setelah dikontrol. Selisih skor OKS sebesar 2,33 poin. Skor WOMAC UKA lebih baik dibandingkan TKA secara signifikan (p < 0,001) setelah dikontrol. Angka revisi UKA sebesar 3,57% selama follow-up rata-rata 11,85 bulan, TKA 21,89 bulan. Analisis bivariat menunjukkan usia dan follow-up berpengaruh signifikan terhadap pemilihan tindakan, sedangkan IMT tidak. Simpulan: UKA menunjukkan luaran fungsional yang lebih baik daripada TKA jika dilakukan pada pasien terpilih dan dikontrol dengan kovariat. Hasil ini mendukung pentingnya pertimbangan selektif dan operator berpengalaman dalam menentukan pilihan tindakan. UKA efektif dan efisien bila indikasi tepat dan dapat menghasilkan luaran fungsional setara atau lebih baik dari TKA.
Kata kunci: UKA, TKA, osteoartritis lutut medial, Oxford Knee Score, WOMAC, ANCOVA


Introduction: Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are primary surgical options for the treatment of medial compartment knee osteoarthritis. UKA offers better functional benefits, but patient selection and surgeon experience significantly influence its success. Objective: To evaluate and compare the clinical outcomes of UKA and TKA in patients with medial knee osteoarthritis at RSCM and RSUP Fatmawati, and to analyze the effect of demographic factors on treatment selection and outcomes. Methods: This retrospective study involved 54 patients at RSUP Fatmawati and RSCM. Outcomes were measured using the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and revision rates. ANCOVA was used to control for covariates such as age, body mass index (BMI), and follow-up duration. Results: OKS scores were significantly higher in the UKA group compared to the TKA group (p < 0.001) after controlling for covariates, with a mean difference of 2.33 points. WOMAC scores were also significantly better in the UKA group (p < 0.001). The UKA revision rate was 3.57% during a mean follow-up period of 11.85 months, compared to 21.89 months in the TKA group. Bivariate analysis showed that age and follow-up duration significantly influenced treatment selection, while BMI did not. Conclusion: UKA demonstrated superior functional outcomes compared to TKA when performed in appropriately selected patients and controlled for covariates. These findings support the importance of selective patient criteria and experienced surgeons in determining treatment. UKA may be a more effective and efficient option when indicated, with outcomes that are equivalent to or better than those of TKA.
Keywords: UKA, TKA, medial knee osteoarthritis, Oxford Knee Score, WOMAC, ANCOVA