Comparison of Fixed-Bearing and Mobile-Bearing Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 34 (12) ◽  
pp. 3114-3123.e3 ◽  
Author(s):  
ZhenWu Cao ◽  
CaiLi Niu ◽  
ChunZhu Gong ◽  
Yong Sun ◽  
JunHui Xie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Unicompartmental Knee

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 33 (02) ◽  
pp. 180-189 ◽  
Author(s):  
Giuseppe Gianluca Costa ◽  
Mirco Lo Presti ◽  
Alberto Grassi ◽  
Giuseppe Agrò ◽  
Sergio Cialdella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Component ◽  
Revision Rate ◽  
Meta Analysis ◽  
Female Patients ◽  
Unicompartmental Knee

AbstractLong-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potential factors that could affect the revision rate. A systematic review was conducted for clinical studies comparing all-polyethylene and metal-backed tibial components used in primary UKAs in terms of revision rates and clinical scores. Meta-regression techniques were used to explore factors modifying the observed effect. All causes of revision were extracted and analyzed, to find statistically significant differences between the two groups. Our research strategy generated a systematic review of nine studies comprising 1,101 UKAs in 1,088 patients with 87 revisions for any reason. Meta-analysis showed a higher, but not statistically significant, risk of aseptic revision in the all-polyethylene group. Studies with a smaller sample size and higher percentage of female patients were correlated to a higher relative risk of revision in favor of all-polyethylene UKAs. Differently, patients' age and duration of follow-up did not influence the risk ratio. The main cause for revision was aseptic loosening in both implants' component, with no statistically differences in the two groups examined. Our results do not show a superiority of the metal-backed tibial component in UKAs in terms of survivorship, although extreme care must be given for patients with high risk of early failure, such as female patients. However, surgical experience, in combination with careful patient selection, remains paramount and may lead to better long-term outcomes in patients requiring UKA. This is a Level III, therapeutic study.

Robotic-Assisted versus Manual Unicompartmental Knee Arthroplasty: Contemporary Systematic Review and Meta-analysis of Early Functional Outcomes

2020 ◽  
Author(s):  
Michael A. Gaudiani ◽  
Linsen T. Samuel ◽  
Atul F. Kamath ◽  
P. Maxwell Courtney ◽  
Gwo-Chin Lee
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Forest Plot ◽  
Robotic Assisted ◽  
Unicompartmental Knee ◽  
Surgeon Experience

AbstractRobotic-assisted unicompartmental knee arthroplasty (RA-UKA) aims to improve accuracy of component placement. Studies have shown improvement in radiographic positioning/alignment with RA-UKA but have not addressed clinical outcome measures (COMs). The purpose of this study was to determine if RA-UKA is associated with improved early revision rates and functional outcome scores (FOS) compared with manual UKA. A systematic review of all English language articles from 1999 to 2019 on RA-UKA using Medline, EMBASE, Scopus, and Web of Science databases identified 277 studies. Seven (three randomized controlled trials) met inclusion criteria. Revision rates/FOS were aggregated for RA-UKA and manual UKA; a forest plot was constructed utilizing inverse variance/Mantel–Haenszel fixed-effects meta-analysis. The seven articles included a total of 363 RA-UKA patients and 425 manual UKA patients. Mean age was 66 ± 3.5 and 65 ± 4.0 years, and mean body mass index (BMI) was 26.8 ± 2.1 and 27.1 ± 1.5 kg/m2, respectively. Mean follow-up was 25.5 months (4.5–48) and 29.1 months (4.5–48) for RA-UKA and manual UKA, respectively. At latest follow-up, RA-UKA patients showed a 26% ± 12 improvement in COMs versus 24% ± 12 improvement for manual UKA patients (p = 0.6). The revision rate was 3% for both groups (p = 0.8); however, a meta-analysis of RCTs showed no difference. Robotic and manual UKAs offer comparable improvements in pain, FOS, and revision rates. The effects of follow-up duration, ceiling effects of COMs, and surgeon experience remain unknown. Future studies comparing robotic versus manual UKAs with longer term follow-up may inform further benefits of each, with respect to component durability, alignment, and functional improvement.

scholarly journals Mobile Versus Fixed Bearing Medial Unicompartmental Knee Arthroplasty: A Series of 375 Patients

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Robert Murphy ◽  
Tyler Fraser ◽  
William Mihalko
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Mobile Bearing ◽  
Lateral Compartment ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Component Loosening

Introduction: We sought to compare outcomes, complications and survival between mobile and fixed bearing medial unicompartmental knee arthroplasty (UKA) in a large multi-surgeon group.Methods: Medical records of patients who underwent a medial UKA were queried between March 2003 and August 2012. Variables investigated included final range of motion (ROM), type of complication, and overall survivorship. Results: 375 medial UKAs were analyzed (308 mobile bearing and 67 fixed bearing). Average time to follow-up was 47 months. Final ROM was comparable (mobile: 1-122°, fixed: 1-120°, p = 0.34). Complications occurred in 20/308 (6.6%) mobile bearing UKA and 5/67 (7.5%) fixed bearing UKA (p = 0.77). The most common complications in mobile bearing implants were progression of lateral compartment disease and component loosening. The complications in fixed bearing implants were arthrofibrosis and tibial plateau fracture. Overall survivorship differed, but not significantly (mobile: 94.8%, fixed: 96.9%, p = 0.44). Discussion: In this largest reported cohort series comparing mobile versus fixed bearing UKA, we found no significant difference in final clinical knee range of motion, rates of complications, and survivorship between the two bearing types. 

scholarly journals Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e044778
Author(s):  
Yifeng Sun ◽  
Wei Liu ◽  
Jian Hou ◽  
Xiuhua Hu ◽  
Wenqiang Zhang
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Robotic Assisted ◽  
Unicompartmental Knee

ObjectiveWe conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.DesignSystematic review and meta-analysis.Data sourcesThe PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.Eligibility criteriaCase–control studies comparing robotic-assisted and conventional UKA.Data extraction and synthesisData from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ2 and I2 tests. All analyses were performed using the ‘metafor’ package of R V.3.6.2 software.ResultsA total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.ConclusionsThis study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.PROSPERO registration numberCRD42021246927.

Sign in / Sign up

Export Citation Format

Share Document