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This study compared mid-term mortality between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in octogenarians, hypothesizing that implant type would not significantly influence patient survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on 238 consecutive octogenarian patients (age\u2009\u2265\u200980 years) who underwent primary knee arthroplasty at a single tertiary orthopaedic center between January 2018 and December 2020. Patients with revision arthroplasty, fracture, tumor, inflammatory arthropathy, or incomplete data were excluded. The primary outcome was all-cause mortality at minimum 5-year follow-up. Secondary outcomes included age-stratified mortality (80\u201384, 85\u201389, \u2265\u200990 years) and identification of independent mortality predictors. Statistical analyses included independent t-tests, chi-square\/Fisher\u2019s exact tests, standardized mean differences, and multivariable logistic regression adjusting for age, follow-up duration, and registry year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 238 patients, 185 (77.7%) underwent TKA and 53 (22.3%) underwent UKA. Overall mortality was 35.3% (84\/238): 33.5% in TKA versus 41.5% in UKA (OR\u2009=\u20091.41, 95% CI: 0.75\u20132.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.329). Age-stratified mortality showed no significant differences: 80\u201384 years (31.2% TKA vs. 37.2% UKA,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.467), 85\u201389 years (42.3% vs. 50.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000). Multivariable analysis identified age as the only significant mortality predictor (adjusted OR\u2009=\u20091.16 per year, 95% CI: 1.03\u20131.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), while implant type was not associated with mortality (adjusted OR\u2009=\u20091.40, 95% CI: 0.72\u20132.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.319). Patient mortality exceeded registry-reported revision rates 3\u20135 fold.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In octogenarians, patient mortality substantially exceeds implant revision risk, with no significant difference between UKA and TKA. Surgeons should prioritize patient-specific clinical indications over theoretical implant durability concerns when selecting procedures in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06466-2","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T15:47:34Z","timestamp":1786031254000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient mortality exceeds implant revision risk with equivalent survival following unicompartmental versus total knee arthroplasty in octogenarians"],"prefix":"10.1007","volume":"146","author":[{"given":"Matteo","family":"Innocenti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1289-8849","authenticated-orcid":false,"given":"Filippo","family":"Leggieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Massenzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stimolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Akkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Matassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Civinini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"6466_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s40520-025-03021-8","volume":"37","author":"V Gianfredi","year":"2025","unstructured":"Gianfredi V, Nucci D, Pennisi F, Maggi S, Veronese N, Soysal P (2025) Aging, longevity, and healthy aging: the public health approach. 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