Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis
The purpose of this study was to compare the revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) with primary TKA through a review of previously published studies. The hypothesis was that the revised UKA group would need additional operative procedures, including the use of stems and augments, resulting in poorer clinical outcomes than those of the primary TKA group.
A literature search of online register databases was performed to identify clinical trials that compared revised UKA to TKA with primary TKA. An electronic literature search was performed using the Medline, Embase, Cochrane Library, Web of Science, and Scopus databases. No language or date restrictions were applied.
A total of 2034 articles were identified from a keyword search, of which 11 studies were determined as eligible. They were all retrospective comparative studies. The revised UKA to TKA group had longer operation times resulting from additional procedures such as bone grafting and use of stems and augments, higher reoperation rates, and worse postoperative clinical outcomes based on the Western Ontario and McMaster Universities Osteoarthritis Index and Oxford Knee Score than the primary TKA group, with the differences being statistically significant.
UKA should not be considered an alternative procedure to TKA.
Level of evidence
Therapeutic Level III.
KeywordsRevision Unicompartmental knee arthroplasty Total knee arthroplasty Systematic review Meta-analysis
No source of funding to declare.
Compliance with ethical standards
Conflict of interest
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This study dealt with published data only, no ethical approval was needed.
For this type of study, formal consent is not required.
- 1.Cankaya D, Della Valle CJ (2016) Blood loss and transfusion rates in the revision of unicompartmental knee arthroplasty to total knee arthroplasty are similar to those of primary total knee arthroplasty but are lower compared with the revision total knee arthroplasty. J Arthroplasty 31:339–341CrossRefPubMedGoogle Scholar
- 10.Kleeblad LJ, van der List JP, Zuiderbaan HA, Pearle AD (2017) Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4817-y PubMedGoogle Scholar
- 12.Leta TH, Lygre SH, Skredderstuen A, Hallan G, Gjertsen JE, Rokne B, Furnes O (2016) Outcomes of unicompartmental knee arthroplasty after aseptic revision to total knee arthroplasty: a comparative study of 768 TKAs and 578 UKAs revised to TKAs from the Norwegian Arthroplasty Register (1994 to 2011). J Bone Joint Surg Am 98:431–440CrossRefPubMedGoogle Scholar
- 19.PRISMA (2009) The PRISMA statement. http://www.prismastatement.org/statement.htm
- 25.WellsGA SB, O’Connell D The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp