Does total knee arthroplasty converted from unicompartmental knee arthroplasty have similar efficacy to primary total knee arthroplasty?

doi:10.3877/cma.j.issn.1674-0785.2017.17.002

Abstract

Abstract:

Objective

To perform a meta-analysis to compare the efficacy between total knee arthroplasty (TKA) converted from unicompartmental knee arthroplasty (UKA) and primary TKA.

Methods

Randomized controlled trails and non-randomized controlled trails comparing TKA converted from UKA with primary TKA were searched in Wanfang Data, CNKI, VIP, PubMed, Springer, EMbase, and Ovid from 2010 to now. RevMan 5.2 software was used to conduct this meta-analysis.

Results

Six retrospective studies [mean Newcastle-Ottawa scale (NOS) score: 7] were eligible for this meta-analysis. There were 238 patients in the revision group, and 358 patients in the primary TKA group. The meta-analysis showed that the revision group had significantly higher re-revision rate than primary TKA (RR=3.30, 95% CI: 1.09~10.06, P=0.04), but there was no difference in the knee function score [MD=-4.92, 95% CI (-4.36, 14.19), P=0.30], range of motion (MD=-5.58, 95% CI: -12.62~1.45, P=0.12), infection rate (MD=0.55, 95% CI: 0.17~1.77, P=0.32), or blood loss (MD=96.03, 95% CI: -155.27~347.32, P=0.45) between the two groups.

Conclusion

TKA converted from UKA can achieve the same effect as primary TKA in the short term, but is associated with a higher re-revision rate.

Key words: Unicompartmental knee arthroplasty, Revision, Primary total knee arthroplasty, Meta-analysis

Yongzhuo Wang, Min Zhang, Yayun Tan, Jinyu Wang, Ji Ma. Does total knee arthroplasty converted from unicompartmental knee arthroplasty have similar efficacy to primary total knee arthroplasty?[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(17): 2167-2172.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2017.17.002

https://zhlcyszz.cma-cmc.com.cn/EN/Y2017/V11/I17/2167

Figures/Tables 6

References 21

[1]	Riddle DL, Jiranek WA, McGlynn FJ. Yearly incidence of unicompartmental knee arthroplasty in the United States [J]. Arthroplasty, 2008, 23(3): 408-412.
[2]	Romanowski MR, Repicci JA. Minimally invasive unicondylar arthroplasty: eight-year follow-up [J]. Knee Surg, 2002, 15(1): 17-22.
[3]	Price AJ, Webb J, Topf H, et al. Rapid recovery after oxford unicompartmental arthroplasty through a short incision [J]. Arthroplasty, 2001, 16(8): 970-976.
[4]	Sierra RJ, Kassel CA, Wetters NG, et al. evision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk [J]. Arthroplasty, 2013, 28(8 Suppl): 128-132.
[5]	Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases [J]. Bone Joint Surg Br, 2011, 93(2): 198-204.
[6]	Pearse AJ, Hooper GJ, Rothwell A, et al. Survival and functional outcome after revision of a unicompartmental to a total knee replacement: the New Zealand National Joint Registry [J]. Bone Joint Surg Br, 2010, 92(4): 508-512.
[7]	Lunebourg A, Parratte S, Ollivier M, et al. Are revisions of unicompartmental knee arthroplasties more like primary or revision TKA? [J]. Arthroplasty, 2015, 30(11): 1985-1989.
[8]	O′Donnell TM, Abouazza O, Neil MJ. Revision of minimal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty [J]. Arthroplasty, 2013, 28(1): 33-39.
[9]	Cross MB, Yi PY, Moric M, et al. Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA? [J]. Arthroplasty, 2014, 29(9 Suppl): 229-231.
[10]	Cankaya D, Della Valle CJ. Blood loss and transfusion rates in the revision of unicompartmental knee arthroplasty to total knee arthroplasty are similar to those of primary total knee arthroplasty but are lower compared with the revision total knee arthroplasty [J]. Arthroplasty, 2016, 31(1): 339-341.
[11]	Jonas SC, Shah R, Mitra A, et al. 5-Year cost/benefit analysis of revision of failed unicompartmental knee replacements (UKRs); not ″just″ aprimary total knee replacement (TKR) [J]. Knee, 2014, 21(4): 840-842.
[12]	Järvenpää J, Kettunen J, Miettinen H. The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primarytotal knee arthroplasty: 8-17 years follow-up study of 49 patients [J]. Int Orthop, 2010, 34(5): 649-653.
[13]	Rodriguez-Merchan EC. Unicompartmental Knee Osteoarthritis (UKOA): Unicompartmental Knee Arthroplasty (UKA) or High Tibial Osteotomy (HTO)? [J]. Arch Bone Jt Surg, 2016, 4(4): 307-313.
[14]	Howell RE, Lombardi AV Jr, Crilly R, et al. Unicompartmental Knee Arthroplasty: Does a Selection Bias Exist? [J]. Arthroplasty, 2015, 30(10): 1740-1742.
[15]	Arirachakaran A, Choowit P, Putananon C. Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic reviewand meta-analysis of randomized controlled trial [J]. Eur J Orthop Surg Traumatol, 2015, 25(5): 799-806.
[16]	Cross MB, Yi PY, Moric M, et al. Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA? [J]. Arthroplasty, 2014, 29(9 Suppl): 229-231.
[17]	Saldanha KA, Keys GW, Svard UC, et al. Revision of Oxford medial unicompartmental knee arthroplasty to total knee arthroplasty- results of amulticentre study [J]. Knee, 2007, 14(4): 275-279.
[18]	Chatain F, Denjean S, Delalande JL, et al. Computer-navigated revision total knee arthroplasty for failed unicompartmental knee arthroplasty [J]. Orthop Traumatol Surg Res, 2012, 98(6): 720-727.
[19]	Pietschmann MF, Ficklscherer A, Wohlleb L, et al. UKA can be safely revised to primary knee arthroplasty by using an autologous bone plate from the proximallateral tibia [J]. Arthroplasty, 2014, 29(10): 1991-1995.
[20]	Schwarzkopf R, Mikhael B, Li L, et al. Effect of initial tibial resection thickness on outcomes of revision UKA [J]. Orthopedics, 2013, 36(4): e409-414.
[21]	Wynn Jones H, Chan W, Harrison T, et al. Revision of medial Oxford unicompartmental knee replacement to a total knee replacement: similar to a primary? [J]. Knee, 2012, 19(4): 339-343.

作者	发表年限	国家	例数	行TKA平均年龄（岁）	性别（男/女）	平均体质量指数（kg/m²）	平均随访时间（年）	NOS评分
Lunebourg等^[7]	2015	法国	U.T 48例	71	12/36	28	7	7
?	?	?	P.T 48例	72	16/32	28	7	?
O′Donnell等^[8]	2013	爱尔兰	U.T 55例	69.3	27/26	30.5	3.3	7
?	?	?	P.T 55例	69.1	27/28	29.8	3.2	?
Cross等^[9]	2014	美国	U.T 49例	61.5	19/30	31.65	4.56	7
?	?	?	P.T 97例	58.9	47/50	32.76	3.59	?
Cankaya等^[10]	2016	美国	U.T 42例	62.1	14/28	31	术后即时	7
?	?	?	P.T 88例	59.5	40/48	31.5	术后即时	?
Jonas等^[11]	2014	英国	U.T 23例	73	7/16	不详	5	7
?	?	?	P.T 42例	70	13/29	不详	5	?
J?rvenp??等^[12]	2010	芬兰	U.T 21例	74.9	9/12	28.6	10.5	7
?	?	?	P.T 28例	75.2	11/17	31.3	10.5	?

作者	发表年限	国家	例数	行TKA平均年龄（岁）	性别（男/女）	平均体质量指数（kg/m²）	平均随访时间（年）	NOS评分
Lunebourg等^[7]	2015	法国	U.T 48例	71	12/36	28	7	7
?	?	?	P.T 48例	72	16/32	28	7	?
O′Donnell等^[8]	2013	爱尔兰	U.T 55例	69.3	27/26	30.5	3.3	7
?	?	?	P.T 55例	69.1	27/28	29.8	3.2	?
Cross等^[9]	2014	美国	U.T 49例	61.5	19/30	31.65	4.56	7
?	?	?	P.T 97例	58.9	47/50	32.76	3.59	?
Cankaya等^[10]	2016	美国	U.T 42例	62.1	14/28	31	术后即时	7
?	?	?	P.T 88例	59.5	40/48	31.5	术后即时	?
Jonas等^[11]	2014	英国	U.T 23例	73	7/16	不详	5	7
?	?	?	P.T 42例	70	13/29	不详	5	?
J?rvenp??等^[12]	2010	芬兰	U.T 21例	74.9	9/12	28.6	10.5	7
?	?	?	P.T 28例	75.2	11/17	31.3	10.5	?

Please choose a citation manager

Content to export