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

Arirachakaran, Alisara; Choowit, Pathompong; Putananon, Chinundorn; Muangsiri, Samart; Kongtharvonskul, Jatupon

doi:10.1007/s00590-015-1610-9

Cited by 144 publications

(86 citation statements)

References 28 publications

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“…The current treatment options for knee arthroplasty are still controversial where both UKA and TKA are both utilized to treat OA and ON. No consistent results have been shown in previous literatures; however, the use of both UKA and TKA has been increasing worldwide [ 15 ]. To our knowledge, this is the first study to examine the national database of patients that have undergone either UKA or TKA from 2005 to 2013 in Taiwan.…”

Section: Discussionmentioning

confidence: 71%

“…By 2025, the percentage of the Taiwan population that is over 65 years old is forecast to increase up by 20% [ 17 ]. Some surgeons still might regard UKA as a temporary procedure and recommend that patients over 60 years of age are still best treated with TKA [ 15 ]. Our research has shown that the age distribution of patients receiving UKA is younger than in TKA.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population-Based Study

Chang

Lee

Lin

et al. 2020

BioMed Research International

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Background. Current treatment options for both unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are still controversial with no consistent results in which one is superior to others. This is the first study to examine and analyze the following related data available in patients receiving either UKA or TKA from the National Health Research Database (NHIRD) in Taiwan. Methods. The database was searched from NHIRD, pooling one million random patients. Patients’ age, gender, and comorbidities were analyzed in either UKA or TKA between January 2005 and December 2013, or up until death. For the patients that had received bilateral surgeries, further subgrouping was divided into TKA to TKA, UKA to UKA, TKA to UKA, and UKA to TKA to analyze the completion rate curve. Additional analysis of the order codes 64202B, 64053B, and 64198B was defined as failures, and the related failure rate curves were analyzed separately within ten years. Finally, infection-related codes were analyzed. Results. 6,179 patients ( n = 276 UKA; n = 5903 TKA) were selected. Age ( p < 0.0001 ) and gender ( p = 0.037 ) had significant differences, with more young population and males having UKA than TKA. Most comorbidities had no significant difference. For the bilateral surgery analysis, the UKA to UKA group had the fastest completion rate ( p < 0.001 ) and UKA to TKA was the slowest. There were no significant differences in the failure rates of 64202B, 64053B, and 64198B. Conclusion. Most UKA and TKA are appropriate solutions to treat patients with osteoarthritis or osteonecrosis. UKA to UKA is the quickest bilateral completion surgery, and UKA has a higher chance of undergoing revision surgery than TKA.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population-Based Study

Chang

Lee

Lin

et al. 2020

BioMed Research International

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“…Kardiovaskuläre, gastrointestinale, pulmonale und neurologische Ereignisse sind die wichtigsten allgemeinen Komplikationen. Dabei ist für den unikondylären Oberflächenersatz eine geringere Komplikationsrate publiziert [23,41]. Lediglich kardiale und neurologische Ereignisse waren in einer der Studien gegenüber dem bikondylären Oberflächenersatz vermehrt [23].…”

Section: Komplikationenunclassified

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

2017

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In end-stage medial osteoarthritis, the surgeon can decide whether to use unicompartmental or total knee arthroplasty for operative treatment of the patient. Despite the available literature there is a lack of evidence to suggest if one procedure can be rated as being superior to the other. With increasing demand for knee arthroplasty, treatment with the highest expectation of success will be of particular interest. The purpose of this manuscript was to analyse and compare the available literature on unicompartmental vs. total knee arthroplasty for the treatment of medial osteoarthritis. In this review of literature, the two procedures were compared regarding their clinical outcome, implant survival, and complication rates. Regarding the clinical outcome the unicompartmental knee arthroplasty was shown to be superior over total knee arthroplasty. However, studies were mostly retrospective and groups were also different preoperatively. Patients treated with unicompartmental knee arthroplasty had better preoperative range of motion and function scores. Unicompartmental and total knee arthroplasty showed comparably increased functional scores. Taking the implant survival as parameter, institutional registries, multicenter studies and arthroplasty registries found total knee arthroplasties to have a significantly better long-term survival in comparison to unicompartmental knee arthroplasty. However, data might be biased by the lower threshold to revise unicompartmental knee arthroplasty due to expected simple revision and more subjective indications for revision. Looking at the complication rate, one has to differentiate between general and implant-specific complications. While the unicompartmental knee arthroplasty was shown to be advantageous in terms of general complications and mortality, it was also shown to be inferior in terms of implant-specific complications. The available literature does not show one procedure to be superior to the other. The trend to a better clinical outcome and a lower mortality rate is advantageous for unicompartmental knee arthroplasty, while the better long-term survival and a lower risk of implant-specific complications may make total knee arthroplasty preferable.

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“…According to the severity and level of impairment, strategies for knee OA-related interventions include surgical and non-surgical approaches [5]. Among the nonsurgical, with prominent clinical use, pharmacologic interventions, which presently present a vast amount of intra-articular treatment approaches with results superior to non-steroidal anti-inflammatory drugs [6,7].…”

Section: Introductionmentioning

confidence: 99%

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

Gomes

Politti

Pereira

et al. 2020

BMC Musculoskelet Disord

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Background: It is not yet clear which of the various electrophysical modalities used in clinical practice is the one that contributes most positively when added to an exercise program in patients with knee osteoarthritis (OA). The aim of the present study was to analyze the clinical effects of the inclusion of interferential current therapy (ICT), shortwave diathermy therapy (SDT) and photobiomodulation (PHOTO) into an exercise program in patients with knee OA. Methods: This prospective, five-arm, randomised, placebo-controlled trial was carried out with blinded participants and examiners. We recruited 100 volunteers aged 40 to 80 years with knee OA. Participants were allocated into five groups: exercise, exercise + placebo, exercise + ICT, exercise + SDT, and exercise + PHOTO. The outcome measures included Western Ontario and McMaster Universities (WOMAC), numerical rating pain scale (NRPS), pressure pain threshold (PPT), self-perceived fatigue and sit-to-stand test (STST), which were evaluated before and after 24 treatment sessions at a frequency of three sessions per week. Results: In all groups, there was a significant improvement (p < 0.05) in all variables over time, except pressure pain threshold. We observed significant differences (p < 0.05) between the groups for WOMAC function (exercise vs. exercise + placebo, mean difference [MD] = 5.55, 95% confidence interval [CI] = 3.63 to 7.46; exercise vs. exercise + ICT, MD = 3.40, 95% CI = 1.46 to 5.33; exercise vs. exercise + SDT, MD = 4.75, 95% CI = 1.85 to 7.64; exercise vs. exercise + PHOTO, MD = 5.45, 95% CI = 3.12 to 7.77) and WOMAC pain, with better scores achieved by the exercise group. However, these differences were not clinically relevant when considering the minimum clinically important difference.

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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

Cited by 144 publications

References 28 publications

Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population-Based Study

Analysis of the following Related Surgeries of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty: A Taiwanese National Health Insurance Research Database Population-Based Study

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

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