title: Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial.
abstract: OBJECTIVE
  To compare clinical outcomes of unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA).
  
  
  METHODS
  A systematic review and meta-regression to compare postoperative outcomes of pain VAS, knee function score, range of motion, complications and revision surgery rates between UKA and TKA were conducted. Relevant randomized controlled trials were identified from MEDLINE and Scopus from inception to August 29, 2014.
  
  
  RESULTS
  Three of 1056 studies were eligible; two, three, two, three and three studies were included in pooling of pain visual analog score (VAS), Knee Society Score (KSS) and Bristol Knee Score (BKS), maximum knee flexion, postoperative complications (aseptic loosening, progressive degenerative joint disease of lateral compartment, bearing dislocation, DVT, fractures and infection) and revision rates, respectively. The unstandardized mean difference (UMD) of the function scores (KSS, BS) for UKA was 1.62 (95 % CI -1.17, 4.42) better than TKA and for pain score was 0.1 (95 % CI -3.54, 3.73) higher than TKA, but both without statistical significance. UKA was more likely to show higher mean maximum knee flexion with a UMD of 1.88 (95 % CI -0.54, 4.30) when compared to TKA, but was also not statistically significant. UKA had a statistically significant lower chance of postoperative complications by 0.35 U (95 % CI 0.12, 0.98) when compared to TKA, but had higher revision rates than TKA with a value of 5.36 (95 % CI 1.06, 27.08).
  
  
  CONCLUSIONS
  In short-term outcomes (5 years or less, with follow-up of 0-5 years), TKA had higher postoperative complications than UKA, but had lower revision rates. There was only one study that reported long-term survivorship (more than 5 years, with follow-up of 5-15 years). Further research that assesses long-term survivorship is necessary to better evaluate UKA and TKA in the treatment of unicompartmental knee osteoarthritis.
authors: Orthopedics Department, Police General Hospital, Bangkok, Thailand, amy.alisara@gmail.com.
authors: Alisara
authors: A
authors: Arirachakaran
authors: Pathompong
authors: P
authors: Choowit
authors: Chinundorn
authors: C
authors: Putananon
authors: Samart
authors: S
authors: Muangsiri
authors: Jatupon
authors: J
authors: Kongtharvonskul
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications; D016059:Range of Motion, Articular