Survival of medial versus lateral unicompartmental knee arthroplasty: A meta-analysis

Abstract

Many studies have found associations between unicompartmental knee arthroplasty (UKA) and implant survival, but controversy still exists regarding the relative survival of medial versus lateral UKA over mid-to long-term follow-up. The purpose of this study was to compare survival and clinical outcomes of medial and lateral UKAs. In this meta-analysis, we reviewed studies that assessed implant survival in patients who underwent medial or lateral UKA with short-to mid-term (<10years) or long-term (>10years) follow-up, and that used assessments, such as pain and function scores, to compare postoperative scores on knee outcome scales. A total of eight studies (33,999 knees with medial UKA and 2,853 with lateral UKA) met the inclusion criteria and was analyzed in detail. There were no significant differences between medial and lateral UKA in pain score (95% CI: -0.37 to 0.88; P = 0.42), function score (95% CI: -0.19 to 0.60; P = 0.31), short-to mid-term survival (medial, 32,083/ 33,483; lateral, 2,636/2,726; OR 0.98, 95% CI: 0.64 to 1.48;P = 0.91), or long-term survival (medial, 479/516; lateral, 110/127; OR 2.51, 95% CI:0.67 to 9.43; P = 0.17). In addition, both groups had substantial proportions of knees with short-to mid-term survival (95.6% by medial UKA and 94.6% by lateral UKA) and long-term survival (92.8% by medial UKA and 86.6% by lateral UKA). This meta-analysis found no significant differences in short-to midterm and long-term survival of medial and lateral UKAs. Similarly, patients treated with medial UKA showed no difference in pain relief or functional improvement compared to patients treated with lateral UKA. These results suggest that both UKA techniques are viable treatment options for patients with unicompartmental knee osteoarthritis over long-term follow-up, although further high-quality studies are needed to address some remaining uncertainties regarding the clinical benefits of these procedures.

Cemented Lateral Unicompartmental Knee Replacement: A retrospective single centre independent series

“…The revision rate in this series is similar to the UK national joint registry for UKR 9 and to the reported survival for the lateral UKR in a recent meta-analysis. 12 These results show that lateral UKR is a reasonable surgical option for patients with isolated lateral compartment arthritis. The overall PROMs scores in this case series are high with nearly two-thirds of patients achieving excellent OKS (41 or above).…”

“…11 While another meta-analysis found no considerable differences in the survival of medial and lateral UKAs. 12 Therefore, the primary aim of this independent series study is to evaluate the survival of lateral UKRs implanted in our institution and their clinical outcomes. The secondary outcome is to compare the results of both mobile and fixed bearing types.…”

Survival of lateral unicompartmental knee arthroplasty at short‐, mid‐, and long‐term follow‐up: a systematic review and meta‐analysis

“…[2][3][4] UKA In contrast to medial UKA which has been widely used, lateral UKA is less frequent, accounting for less than 1% of the total number of knee arthroplasties and about 5%-10% of all UKAs. 1,5 The rarity of isolated lateral knee OA, which is 10 times less common than isolated medial knee OA, 1 could be a factor at play. In addition, lateral UKA is considered to be more technically challenging owing to its anatomic and biomechanical characteristics.…”

“…In addition, lateral UKA is considered to be more technically challenging owing to its anatomic and biomechanical characteristics. 5 Extensive literature is available regarding medial UKA, showing good survival outcomes. 6 Even though modern reports on lateral UKA have shown similar advantages with excellent survivorship, [7][8][9] the reliability of lateral UKA has yet to be elucidated.…”

Lateral unicompartmental knee arthroplasty: A review

“…Recently, a meta-analysis of survival between medial and LUKAs showed no difference in short, mid-term, and long-term survival. In addition, there was no difference in pain relief or functional improvement between the two procedures[ 25 ].…”