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Review
. 2018 Jun 22;13(1):158.
doi: 10.1186/s13018-018-0859-1.

A Meta-Analysis of Unicompartmental Knee Arthroplasty Revised to Total Knee Arthroplasty Versus Primary Total Knee Arthroplasty

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Free PMC article
Review

A Meta-Analysis of Unicompartmental Knee Arthroplasty Revised to Total Knee Arthroplasty Versus Primary Total Knee Arthroplasty

Xuedong Sun et al. J Orthop Surg Res. .
Free PMC article

Abstract

Background: This study was performed to compare the clinical outcomes of unicompartmental knee arthroplasty (UKA) revised to total knee arthroplasty (TKA) versus primary TKA.

Methods: Relevant trials were identified via a search of the Cochrane Central Register of Controlled Trials and PubMed from inception to 17 June 2017. A meta-analysis was performed to compare postoperative outcomes between revised UKA and primary TKA with respect to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS), mean polyethylene thickness, hospital stay, revision rate, range of motion (ROM), and complications.

Results: Five of 233 studies involving 536 adult patients (revised UKA group, n = 209; primary TKA group, n = 327) were eligible for inclusion in the meta-analysis. The primary TKA group had better WOMAC scores, KSS, and ROM than the revised UKA group (P < 0.05). Compared with primary TKA, revision of UKA to TKA required more augments, stems, and bone grafts and a thicker polyethylene component (P < 0.05). There were no significant differences between the two groups in the revision rate, hospital stay, or complications (P > 0.05).

Conclusion: Conversion of UKA to TKA is associated with poorer clinical outcomes than primary TKA. Furthermore, we believe that conversion of UKA to TKA is more complicated than performing primary TKA. Revision UKA often requires more augments, stems, and bone grafts and thicker polyethylene components than primary TKA. However, patients who undergo conversion of UKA to TKA have similar hospital stay, complications, and revision rate as patients who undergo primary TKA.

Keywords: Knee osteoarthritis; Meta-analysis; Total knee arthroplasty; Unicompartmental knee arthroplasty.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by Weifang People’s Hospital Institutional Review Board.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of study selection
Fig. 2
Fig. 2
Funnel plot for requirement of augments, stems, and bone grafts
Fig. 3
Fig. 3
Forest plot for hospital stay
Fig. 4
Fig. 4
Forest plot for complications
Fig. 5
Fig. 5
Forest plot for revision rates
Fig. 6
Fig. 6
Forest plot for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scores
Fig. 7
Fig. 7
Forest plot for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores
Fig. 8
Fig. 8
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) stiffness scores
Fig. 9
Fig. 9
Forest plot for Knee Society Function Score
Fig. 10
Fig. 10
Forest plot for Knee Society Knee Score
Fig. 11
Fig. 11
Forest plot for range of motion (ROM)
Fig. 12
Fig. 12
Forest plot for polyethylene thickness
Fig. 13
Fig. 13
Forest plot for requirement of augments, stems, and bone grafts

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