Literature DB >> 25676725

Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial.

Alisara Arirachakaran1, Pathompong Choowit, Chinundorn Putananon, Samart Muangsiri, Jatupon Kongtharvonskul.   

Abstract

OBJECTIVE: To compare clinical outcomes of unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA).
METHODS: A systematic review and meta-regression to compare postoperative outcomes of pain VAS, knee function score, range of motion, complications and revision surgery rates between UKA and TKA were conducted. Relevant randomized controlled trials were identified from MEDLINE and Scopus from inception to August 29, 2014.
RESULTS: Three of 1056 studies were eligible; two, three, two, three and three studies were included in pooling of pain visual analog score (VAS), Knee Society Score (KSS) and Bristol Knee Score (BKS), maximum knee flexion, postoperative complications (aseptic loosening, progressive degenerative joint disease of lateral compartment, bearing dislocation, DVT, fractures and infection) and revision rates, respectively. The unstandardized mean difference (UMD) of the function scores (KSS, BS) for UKA was 1.62 (95 % CI -1.17, 4.42) better than TKA and for pain score was 0.1 (95 % CI -3.54, 3.73) higher than TKA, but both without statistical significance. UKA was more likely to show higher mean maximum knee flexion with a UMD of 1.88 (95 % CI -0.54, 4.30) when compared to TKA, but was also not statistically significant. UKA had a statistically significant lower chance of postoperative complications by 0.35 U (95 % CI 0.12, 0.98) when compared to TKA, but had higher revision rates than TKA with a value of 5.36 (95 % CI 1.06, 27.08).
CONCLUSION: In short-term outcomes (5 years or less, with follow-up of 0-5 years), TKA had higher postoperative complications than UKA, but had lower revision rates. There was only one study that reported long-term survivorship (more than 5 years, with follow-up of 5-15 years). Further research that assesses long-term survivorship is necessary to better evaluate UKA and TKA in the treatment of unicompartmental knee osteoarthritis.

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Mesh:

Year:  2015        PMID: 25676725     DOI: 10.1007/s00590-015-1610-9

Source DB:  PubMed          Journal:  Eur J Orthop Surg Traumatol        ISSN: 1633-8065


  26 in total

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Journal:  J Arthroplasty       Date:  2002-12       Impact factor: 4.757

2.  No deterioration of kinematics and cruciate function 10 years after medial unicompartmental arthroplasty.

Authors:  D Hollinghurst; J Stoney; T Ward; H S Gill; J H Newman; D W Murray; D J Beard
Journal:  Knee       Date:  2006-09-14       Impact factor: 2.199

3.  GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

Authors:  Gordon H Guyatt; Andrew D Oxman; Gunn E Vist; Regina Kunz; Yngve Falck-Ytter; Pablo Alonso-Coello; Holger J Schünemann
Journal:  BMJ       Date:  2008-04-26

4.  Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis.

Authors:  J H Newman; C E Ackroyd; N A Shah
Journal:  J Bone Joint Surg Br       Date:  1998-09

5.  Mobile bearing UKA compared to fixed bearing TKA: a randomized prospective study.

Authors:  Peng-Fei Sun; Yu-Hua Jia
Journal:  Knee       Date:  2011-02-22       Impact factor: 2.199

6.  Comparison of HRQL between unicompartmental knee arthroplasty and total knee arthroplasty for the treatment of osteoarthritis.

Authors:  Katie Sweeney; Maja Grubisic; Carlo A Marra; Richard Kendall; Linda C Li; Larry D Lynd
Journal:  J Arthroplasty       Date:  2013-07-11       Impact factor: 4.757

7.  Unicompartmental or total knee arthroplasty?: Results from a matched study.

Authors:  Anish K Amin; James T Patton; Robert E Cook; Mark Gaston; Ivan J Brenkel
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8.  Total knee replacement in young, active patients. Long-term follow-up and functional outcome.

Authors:  D R Diduch; J N Insall; W N Scott; G R Scuderi; D Font-Rodriguez
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9.  The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

Authors:  Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher
Journal:  PLoS Med       Date:  2009-07-21       Impact factor: 11.069

10.  Unicompartmental versus total knee arthroplasty in the same patient. A comparative study.

Authors:  C T Laurencin; S B Zelicof; R D Scott; F C Ewald
Journal:  Clin Orthop Relat Res       Date:  1991-12       Impact factor: 4.176

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  35 in total

1.  Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term.

Authors:  Tilman Walker; Pit Hetto; Thomas Bruckner; Tobias Gotterbarm; Christian Merle; Benjamin Panzram; Moritz M Innmann; Babak Moradi
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2018-11-21       Impact factor: 4.342

2.  Total versus partial knee replacement in patients with medial compartment knee osteoarthritis: the TOPKAT RCT.

Authors:  David J Beard; Loretta J Davies; Jonathan A Cook; Graeme MacLennan; Andrew Price; Seamus Kent; Jemma Hudson; Andrew Carr; Jose Leal; Helen Campbell; Ray Fitzpatrick; Nigel Arden; David Murray; Marion K Campbell
Journal:  Health Technol Assess       Date:  2020-04       Impact factor: 4.014

3.  The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study.

Authors:  Geert Peersman; Jeroen Verhaegen; Barbara Favier
Journal:  Int Orthop       Date:  2019-05-21       Impact factor: 3.075

4.  The best cited articles of the European Journal of Orthopaedic Surgery and Traumatology (EJOST): a bibliometric analysis.

Authors:  Andreas F Mavrogenis; Panayiotis D Megaloikonomos; Cyril Mauffrey; Marius M Scarlat; Patrick Simon; Kazuhiro Hasegawa; Samo K Fokter; Pierre Kehr
Journal:  Eur J Orthop Surg Traumatol       Date:  2018-02-14

5.  Knee strength, power and stair performance of the elderly 5 years after unicompartmental knee arthroplasty.

Authors:  Yumeng Li; Rumit S Kakar; Yang-Chieh Fu; Ormonde M Mahoney; Tracy L Kinsey; Kathy J Simpson
Journal:  Eur J Orthop Surg Traumatol       Date:  2018-04-13

6.  Dependence of knee range of motion on the alignment of femoral and tibial components after medial unicompartmental knee arthroplasty.

Authors:  Mitsuru Hanada; Kensuke Hotta; Yukihiro Matsuyama
Journal:  Eur J Orthop Surg Traumatol       Date:  2020-08-20

7.  Medium-term outcome of cementless, mobile-bearing, unicompartmental knee arthroplasty.

Authors:  Radosław Stempin; Kacper Stempin; Wiesław Kaczmarek
Journal:  Ann Transl Med       Date:  2019-02

8.  [Comparison of early effectiveness and safety of simultaneous and staged bilateral unicompartmental knee arthroplasty for bilateral anteromedial compartment osteoarthritis].

Authors:  Zhiyuan Su; Juncai Liu; Xiangtian Deng; Yunong Ao; Daiqing Wei; Yun Luo; Zhong Li
Journal:  Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi       Date:  2019-07-15

Review 9.  Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis.

Authors:  Meichao Deng; Yang Hu; Zhongzu Zhang; Hongjun Zhang; Yiming Qu; Gaohai Shao
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10.  Pinless Navigation in Unicompartmental Knee Arthroplasty.

Authors:  Sarah Keuntje-Perka; Philipp von Roth; Michael Worlicek; Matthias Koch; Volker Alt; Moritz Kaiser
Journal:  J Clin Med       Date:  2021-05-30       Impact factor: 4.241

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