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

  • General Review • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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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Acknowledgments

All authors declare no funding source or sponsor involvement in the study design, collection, analysis and interpretation of the data, in writing the manuscript and in submission of the manuscript for publication.

Conflict of interest

All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Orthopedics Department, Police General Hospital, Bangkok, Thailand

    Alisara Arirachakaran, Pathompong Choowit, Chinundorn Putananon & Samart Muangsiri

  2. Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand

    Jatupon Kongtharvonskul

Authors
  1. Alisara Arirachakaran
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  2. Pathompong Choowit
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  3. Chinundorn Putananon
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  4. Samart Muangsiri
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Correspondence to Jatupon Kongtharvonskul.

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Arirachakaran, A., Choowit, P., Putananon, C. et al. Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial. Eur J Orthop Surg Traumatol 25, 799–806 (2015). https://doi.org/10.1007/s00590-015-1610-9

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  • DOI: https://doi.org/10.1007/s00590-015-1610-9

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