Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis

  • Jin Kyu Lee
  • Hyun Jung Kim
  • Jae Ok Park
  • Jae-Hyuk Yang



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.


Revision 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.

Ethical approval

This study dealt with published data only, no ethical approval was needed.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

167_2018_4909_MOESM1_ESM.doc (70 kb)
Supplementary material 1 (DOC 70 KB)


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Jin Kyu Lee
    • 1
  • Hyun Jung Kim
    • 2
  • Jae Ok Park
    • 3
  • Jae-Hyuk Yang
    • 4
  1. 1.Department of Orthopaedic SurgeryHanyang University HospitalSeoulSouth Korea
  2. 2.Department of Preventive MedicineCollege of Medicine, Korea UniversitySeoulSouth Korea
  3. 3.Medical LibraryVeterans Health Service Medical CenterSeoulSouth Korea
  4. 4.Department of Orthopedic SurgeryHanyang University Guri HospitalGuriSouth Korea

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