Unicompartmental versus total knee arthroplasty for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trial

Abstract

Objective: To evaluate the operative time, intraoperative blood loss, incision length, length of hospital stay, postoperative joint function recovery, and complications of unicompartmental knee arthroplasty (UKA) and total knee replacement (total knee arthroplasty, TKA) in order to compare the differences between the 2 methods in the treatment of single-compartment knee osteoarthritis. Materials and methods: Computer retrieval Pubmed, Embase, the Cochrane, Sinomed, CNKI, WangFang, and VIP database of UKA and TKA osteoarthritis knee single room curative effect comparison, retrieval time limit for a library to November 2020, consult the reference index can be obtained at the same time. Two researchers independently screened the retrieved literature according to the established inclusion and exclusion criteria. Operative time, incision length, intraoperative blood loss, length of hospital stay, postoperative hospital for special surgery score, American knee society knee score, and excellent rateof pain relief were used as the main evaluation indexes, postoperative flexion degree, postoperative visual analogue scale score, time required for active kneeling to 90 degrees, and hemoglobin decrease in 72 hours and postoperative complications were used as secondary evaluation indexes. The methodological quality was evaluated and meta-analysis was performed using Stata 16.0 software. Results: A total of 54 articles were included, including a total of 4577 patients. Meta-analysis results showed that the UKA group was superior to the TKA group in terms of early postoperative knee function score, postoperative pain relief, hemoglobin reduction at 72 hours and complications, and the differences were statistically significant (P<0.05). At the same time, the amount of intraoperative blood loss, length of hospital stay, operative time, incision length and the time required for active kneeling to 90 degrees in the UKA group were less than those in the TKA group, and the differences were statistically significant (P<0.05). The UKA group had fewer early complications but higher long-term revision rate than the TKA group. Conclusion: UKA is superior to TKA in the treatment of single-compartment knee osteoarthritis during surgery and in early stage patients, but patients with UKA are at high risk of long-term revision.