Purpose: To investigate the outcomes of UKR in over 75-year olds in terms of peri-operative morbidity; length of hospital stay and patient reported outcomes (Oxford knee score). Method: A six-year retrospective study of Unilateral Knee Replacements (UKRs) operated on by an experienced consultant orthopaedic surgeon assessed with serial Oxford Knee Scores. The patient selection criteria was based on age, over 75 years old. Secondary outcomes recorded included the length of stay and postoperative

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... complications. Results: Eighteen UKRs were implanted into 16 patients with 2 receiving bilateral UKRs. The mean age at the time of surgery was 77.6 (range 75-87 years). No intra-operative complications or major immediate post-operative complication was observed. No patients required a post-operative blood transfusion and the average length of hospital stay was 4.6 days (+/-1.34). At the 1-year post-operative follow-up the Oxford Knee Score was 34.7 (+/-8.3) increasing to a maximum score of 38.8(+/-4.4) at 4 years postoperative follow-up. During the 5th and 6th postoperative year, the Oxford Knee Score started to decline slightly at 33.5 (+/-6.4) and 32 (+/-11.3) respectively. No patients received revision surgery. Significance: The scores from this study are comparable to that of a total knee replacement in a similar age group. As such UKRs can be a viable alternative to a total knee arthroplasty in an elderly population with multiple comorbidities who may benefit from a less invasive procedure.