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Unicompartmental knee arthroplasty , is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis ? A meta-analysis and systemic review
| Content Provider | Semantic Scholar |
|---|---|
| Author | Skou, Søren Thorgaard Roos, Ewa M. Laursen, Mogens Berg Rathleff, Michael Skovdal Simonsen, Ole |
| Copyright Year | 2018 |
| Abstract | Unicompartmental knee arthroplasty (UKA) has advantages over total knee arthroplasty but national joint registries report a significantly higher revision rate for UKA. As a result, most surgeons are highly selective, offering UKA only to a small proportion (up to 5%) of patients requiring arthroplasty of the knee, and consequently performing few each year. However, surgeons with large UKA practices have the lowest rates of revision. The overall size of the practice is often beyond the surgeon’s control, therefore case volume may only be increased by broadening the indications for surgery, and offering UKA to a greater proportion of patients requiring arthroplasty of the knee. The aim of this study was to determine the optimal UKA usage (defined as the percentage of knee arthroplasty practice comprised by UKA) to minimise the rate of revision in a sample of 41 986 records from the for National Joint Registry for England and Wales (NJR). UKA usage has a complex, non-linear relationship with the rate of revision. Acceptable results are achieved with the use of 20% or more. Optimal results are achieved with usage between 40% and 60%. Surgeons with the lowest usage (up to 5%) have the highest rates of revision. With optimal usage, using the most commonly used implant, five-year survival is 96% (95% confidence interval (CI) 94.9 to 96.0), compared with 90% (95% CI 88.4 to 91.6) with low usage (5%) previously considered ideal. The rate of revision of UKA is highest with low usage, implying the use of narrow, and perhaps inappropriate, indications. The widespread use of broad indications, using appropriate implants, would give patients the advantages of UKA, without the high rate of revision. J Orthop Surg Res. 2017 Mar 28;12(1):50. doi: 10.1186/s13018-017-0552-9. Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review. Santoso MB, Wu L. Author information Abstract BACKGROUND: Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. METHODS: We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a metaanalysis. RESULTS: No significant difference between the two groups was noted with respect to free walking (velocity), knee score, deterioration of the contralateral or patellofemoral knee, or revision rate and total knee arthroplasty. However, UKA produced better outcomes compared to HTO in terms of the functional results, pain assessment, and complications, although patients who underwent HTO tended to have slightly better range of motion. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.stvincentsboneandjoint.com.au/pdf/ukr-references.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
