Comparison of Fixed-Bearing and Mobile-Bearing Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

J Arthroplasty. 2019 Dec;34(12):3114-3123.e3. doi: 10.1016/j.arth.2019.07.005. Epub 2019 Jul 30.

Abstract

Background: Prior studies have compared fixed-bearing unicompartmental knee arthroplasty (FB-UKA) with mobile-bearing UKA (MB-UKA), suggesting that both procedures have good clinical outcomes. However, which treatment is more beneficial for patients is controversial. The purpose of our study is to evaluate the postoperative outcomes, including the revision rate, complications, functional results, range of motion, and femoral-tibial angle, between the 2 procedures.

Methods: We searched the MEDLINE, EMBASE, Cochrane Library, and Web of Science databases starting from August 2017 to May 2018. The publication date of articles was not restricted. Before we submit our contribution, we have re-searched it again. Articles that directly compared the postoperative outcomes of the 2 prosthesis type were included.

Results: A total of 15 comparative studies were included in our meta-analysis. The pooled data indicated no differences between the 2 operation modes in terms of revision rates, complications, and knee function, but earlier failure occurred more frequently with the MB design.

Conclusion: Both the arthroplasty types provided satisfactory clinical results for patients with classic indications. However, MB-UKA tended to fail in early postoperative years whereas fixed-bearing UKA in later postoperative years. Therefore treatment options should be carefully considered for each patient, and surgeons should still use their personal experience when deciding between these options.

Keywords: fixed bearing; meta-analysis; mobile bearing; systematic review; unicompartmental knee arthroplasty.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Arthroplasty, Replacement, Knee / instrumentation*
  • Arthroplasty, Replacement, Knee / statistics & numerical data
  • Female
  • Femur / surgery
  • Humans
  • Knee / surgery
  • Knee Joint / surgery
  • Knee Prosthesis*
  • Male
  • Osteoarthritis, Knee / surgery
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Period
  • Prosthesis Design / adverse effects
  • Prosthesis Design / statistics & numerical data*
  • Range of Motion, Articular
  • Recovery of Function
  • Reoperation / statistics & numerical data
  • Tibia / surgery
  • Treatment Outcome