Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain
The aim of this review article is to analyze the clinical effectiveness of total knee replacement (TKR) compared to unicompartmental knee replacement (UKR) in patients with medial unicompartmental osteoarthritis (MUO) in terms of survival rates, revision rates and postoperative complications. The search engine was MedLine. The keywords used were: medial knee osteoarthritis. Three thousand and ninety-six articles were found on 28 April 2014. Of those, only twenty-eight were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, patients who undergo UKR have higher revision rates and lower survival rates at 5, 10 and 15 years. The reported overall risk of postoperative complications for patients undergoing TKR is 11%, compared with 4.3% for patients undergoing UKR. In conclusion, UKR have higher revision rates and lower survival rates than TKR. There is, however, an increased risk of postoperative complications after TKR.
Sweeney K, Grubisic M, Marra CA, Kendall R, Li LC, Lynd LD. Comparison of HRQL between unicompartmental knee arthroplasty and total knee arthroplasty for the treatment of osteoarthritis. J Arthroplasty. 2013; 28:187-90.
Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79:499-507.
Beard DJ, Holt MD, Mullins MM, Malek S, Massa E, Price AJ. Decision making for knee replacement: variation in treatment choice for late stage medial compartment osteoarthritis. Knee. 2012; 19:886-9.
Lyons MC, MacDonald SJ, Somerville LE, Naudie DD, McCalden RW. Unicompartmental versus total knee arthroplasty database analysis: is there a winner?. Clin Orthop Relat Res. 2012; 470:84-90.
Woolson ST, Shu B, Giori NJ. Incidence of radiographic unicompartmental arthritis in patients undergoing knee arthroplasty. Orthopedics. 2010; 33:798.
Pandit H, Gulati A, Jenkins C, Barker K, Price AJ, Dodd CA, et al. Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment. Knee. 2011; 18:168-71.
Niinimäki TT, Murray DW, Partanen J, Pajala A, Leppilahti JI. Unicompartmental knee arthroplasties implanted for osteoarthritis with partial loss of joint space have high re-operation rates. Knee. 2011; 18:432-5.
Xing Z, Katz J, Jiranek W. Unicompartmental knee arthroplasty: factors influencing the outcome. J Knee Surg. 2012; 25:369-73.
Rougraff BT, Heck DA, Gibson AE. A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res. 1991; 273:157-64.
Yang S, Hadlow S. Unicompartmental knee arthroplasty: is it durable?. N Z Med J. 2003; 116(1183):627.
Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ. Unicompartmental or total knee arthroplasty?: Results from a matched study. Clin Orthop Relat Res. 2006; 451:101-6.
Gioe TJ, Novak C, Sinner P, Ma W, Mehle S. Knee arthroplasty in the young patient: survival in a community registry. Clin Orthop Relat Res. 2007; 464:83-7.
Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 kneereplacements from the Finnish Arthroplasty Register. Acta Orthop. 2008; 79:499-507.
Foran JR, Brown NM, Della Valle CJ, Berger RA, Galante JO. Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res. 2013; 471:102-8.
Niinimäki T, Eskelinen A, Mäkelä K, Ohtonen P, Puhto AP, Remes V. Unicompartmental knee arthroplasty survivorship is lower than TKA survivorship: A 27-year Finnish Registry study. Clin Orthop Relat Res. 2014; 472(5):1496-501.
Costa CR, Johnson AJ, Mont MA, Bonutti PM. Unicompartmental and total knee arthroplasty in the same patient. J Knee Surg. 2011; 24(4):273-8.
Newman J, Pydisetty RV, Ackroyd C. Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Br. 2009;91(1):52-7.
Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, et al. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res. 1999; 367:50-60.
Kristensen PW, Holm HA, Varnum C. Up to 10-year follow-up of the Oxford medial partial knee arthroplasty--695 cases from a single institution. J Arthroplasty. 2013;28:195-8.
Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM. Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty. 2008; 23(2):159-63.
Manson TT, Kelly NH, Lipman JD, Wright TM, Westrich GH. Unicondylar knee retrieval analysis. J Arthroplasty. 2010; 25:108-11.
Parratte S, Pauly V, Aubaniac JM, Argenson JN. No long-term difference between fixed and mobile medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2012; 470:61-8.
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 ;28:33-9.
Oduwole KO, Sayana MK, Onayemi F, McCarthy T, O’Byrne J. Analysis of revision procedures for failed unicondylar knee replacement. Ir J Med Sci. 2010; 179:361-4.
Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for Hip and Knee. Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res. 2012; 98:124-30.
Bergeson AG, Berend KR, Lombardi AV Jr, Hurst JM, Morris MJ, Sneller MA. Medial mobile bearing unicompartmental knee arthroplasty: early survivorship and analysis of failures in 1000 consecutive cases. J Arthroplasty. 2013; 28:172-5.
Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, et al. Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplasty. 2012; 27:86-90.