Evidence brief
Total or Partial Knee Arthroplasty Trial (TOPKAT)
No significant difference in Oxford Knee Score at 5 years
UKA had higher reoperation rate (13% vs 4%)
TKA had longer hospital stay and slower early recovery
UKA more cost-effective at 5 years
528 patients randomized across 68 UK centers
TOPKAT demonstrated that both UKA and TKA are effective for isolated medial compartment OA. UKA offers faster recovery and lower cost but higher reoperation rate. Patient selection and surgeon experience are crucial.
Key trial for compartmental OA discussion. Know the 5-year results: similar function, UKA faster recovery but higher revision. Discuss patient selection for UKA (intact ACL, correctable deformity, no inflammatory arthritis, reasonable weight). Reference AOANJRR for revision rates.
Level I
Systematic review of RCTs or high-quality RCT