Return to Sports after hypoallergenic and standard Cobalt Ch
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A Study was conducted to compare the rate of return to sports and body mass index (BMI) reduction in patients who underwent surgery for unicompartmental knee arthroplasty (UKA) with either Cobalt-Chromium (CoCr) alloy UKA or with hypoallergenic UKA, stratified by age, gender and BMI.

Two consecutive cohorts of patients with a total of 172 UKA and a minimum 2-year follow-up period were prospectively included in this comparative study. The first cohort consisted of 136 consecutive series of standard Cobalt-Chromium (CoCr Group). The second cohort consisted of 36 consecutive mobile-bearing hypoallergenic Titanium Niobium Nitride UKA, (TiNbN Group). The clinical evaluation was based on the University of California, Los Angeles (UCLA) activity scores and the High-Activity Arthroplasty Score (HAAS) evaluated on the day before surgery (T0) and after a minimum follow-up of 12 months (T1) and 24 months (T2). Radiographic evaluation performed at T2 included the femoral component position in varus/valgus, the tibial component in varus/valgus and the anteroposterior slope.

--No statistical differences were found between the groups at each follow-up, as shown by the UCLA and HAAS score (n.s.).

--Both groups showed a statistically significant improvement at each follow-up. Both groups showed a statistically significant BMI reduction between T0 and T2.

--Radiographic analysis revealed no statistical differences between the two groups in terms of the three measures after the final follow-up.

--All the subgroups showed a significant rate of return to sport if compared with the preoperative value (T2 versus T0), except for male in TiNbN group.

In particular, both TiNbN and CoCr medial mobile-bearing UKA allowed patients, irrespective of age, BMI, gender and metal sensitivity, to return to sports following final follow-up. These results inform shared decision-making and can help to manage patient expectations after surgery, especially in active patients with an overt metal allergy, the gold standard implant in partial knee replacement surgery should be considered a specific hypoallergenic implant.