Skip to main content
SpringerLink
Log in

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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

UKA should not be considered an alternative procedure to TKA.

Level of evidence

Therapeutic Level III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  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 31:339–341

    Article  Google Scholar 

  2. Craik JD, El Shafie SA, Singh VK, Twyman RS (2015) Revision of unicompartmental knee arthroplasty versus primary total knee arthroplasty. J Arthroplasty 30:592–594

    Article  Google Scholar 

  3. Cross MB, Yi PY, Moric M, Sporer SM, Berger RA, Della Valle CJ (2014) Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA? J Arthroplasty 29:229–231

    Article  Google Scholar 

  4. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  Google Scholar 

  5. Jarvenpaa J, Kettunen J, Miettinen H, Kroger H (2010) The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients. Int Orthop 34:649–653

    Article  Google Scholar 

  6. Jonas SC, Shah R, Mitra A, Deo SD (2014) 5-Year cost/benefit analysis of revision of failed unicompartmental knee replacements (UKRs); not “just” a primary total knee replacement (TKR). Knee 21:840–842

    Article  Google Scholar 

  7. Kim KT, Lee S, Lee JI, Kim JW (2016) Analysis and Treatment of Complications after Unicompartmental Knee Arthroplasty. Knee Surg Relat Res 28:46–54

    Article  Google Scholar 

  8. Kim KT, Lee S, Lee JS, Kang MS, Koo KH (2018) Long-term clinical results of unicompartmental knee arthroplasty in patients younger than 60 years of age: minimum 10-year Follow-up. Knee Surg Relat Res 30:28–33

    Article  Google Scholar 

  9. Kim YJ, Kim BH, Yoo SH, Kang SW, Kwack CH, Song MH (2017) Mid-term results of Oxford medial unicompartmental knee arthroplasty in young asian patients less than 60 years of age: a minimum 5-year follow-up. Knee Surg Relat Res 29:122–128

    Article  Google 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

    Article  PubMed  Google Scholar 

  11. Ko YB, Gujarathi MR, Oh KJ (2015) Outcome of unicompartmental knee arthroplasty: a systematic review of comparative studies between fixed and mobile bearings focusing on complications. Knee Surg Relat Res 27:141–148

    Article  Google 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 98:431–440

    Article  Google Scholar 

  13. Lum ZC, Crawford DA, Lombardi AV Jr, Hurst JM, Morris MJ, Adams JB, Berend KR (2018) Early comparative outcomes of unicompartmental and total knee arthroplasty in severely obese patients. Knee. https://doi.org/10.1016/j.knee.2017.10.006

    Article  PubMed  Google Scholar 

  14. Lunebourg A, Parratte S, Ollivier M, Abdel MP, Argenson JN (2015) Are revisions of unicompartmental knee arthroplasties more like a primary or revision TKA? J Arthroplasty 30:1985–1989

    Article  Google Scholar 

  15. O’Donnell TM, Abouazza O, Neil MJ (2013) Revision of minimal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty. J Arthroplasty 28:33–39

    Article  Google Scholar 

  16. Pearse AJ, Hooper GJ, Rothwell A, Frampton C (2010) Survival and functional outcome after revision of a unicompartmental to a total knee replacement: the New Zealand National Joint Registry. J Bone Joint Surg Br 92:508–512

    Article  CAS  Google Scholar 

  17. Pearse AJ, Hooper GJ, Rothwell AG, Frampton C (2012) Osteotomy and unicompartmental knee arthroplasty converted to total knee arthroplasty: data from the New Zealand Joint Registry. J Arthroplasty 27:1827–1831

    Article  Google Scholar 

  18. Pietschmann MF, Ficklscherer A, Wohlleb L, Schmidutz F, Jansson V, Muller PE (2014) UKA can be safely revised to primary knee arthroplasty by using an autologous bone plate from the proximal lateral tibia. J Arthroplasty 29:1991–1995

    Article  Google Scholar 

  19. PRISMA (2009) The PRISMA statement. http://www.prismastatement.org/statement.htm

  20. Rancourt MF, Kemp KA, Plamondon SM, Kim PR, Dervin GF (2012) Unicompartmental knee arthroplasties revised to total knee arthroplasties compared with primary total knee arthroplasties. J Arthroplasty 27:106–110

    Article  Google Scholar 

  21. Robertsson O, A WD (2015) The risk of revision after TKA is affected by previous HTO or UKA. Clin Orthop Relat Res 473:90–93

    Article  Google Scholar 

  22. Ryu SM, Park JW, Na HD, Shon OJ (2018) High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis with kissing lesions in relatively young patients. Knee Surg Relat Res 30:17–22

    Article  Google Scholar 

  23. Saldanha KAN, Keys GW, Svard UCG, White SH, Rao C (2007) Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty—results of a multicentre study. Knee 14:275–279

    Article  CAS  Google Scholar 

  24. Saragaglia D, Estour G, Nemer C, Colle PE (2009) Revision of 33 unicompartmental knee prostheses using total knee arthroplasty: strategy and results. Int Orthop 33:969–974

    Article  Google Scholar 

  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

  26. Xia Z, Liow MHL, Goh GS, Chong HC, Lo NN, Yeo SJ (2017) Body mass index changes after unicompartmental knee arthroplasty do not adversely influence patient outcomes. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4703-7

    Article  PubMed  Google Scholar 

Download references

Funding

No source of funding to declare.

Author information

Author notes

  1. The first two authors (Jin Kyu Lee, Hyun Jung Kim) contributed equally.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, South Korea

    Jin Kyu Lee

  2. Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea

    Hyun Jung Kim

  3. Medical Library, Veterans Health Service Medical Center, Seoul, South Korea

    Jae Ok Park

  4. Department of Orthopedic Surgery, Hanyang University Guri Hospital, 153, Gyeongchunro, Guri, Gyeonggi-Do, 11923, South Korea

    Jae-Hyuk Yang

Authors
  1. Jin Kyu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyun Jung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Ok Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae-Hyuk Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jae-Hyuk Yang.

Ethics declarations

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.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 70 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, J.K., Kim, H.J., Park, J.O. et al. Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 26, 3403–3418 (2018). https://doi.org/10.1007/s00167-018-4909-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-018-4909-3

Keywords

Search

Navigation