Department of Orthopaedics, Weifang People's Hospital, no. 151 Guangwen Road, Weifang, 260041, China.
Department of Medical Oncology, Weifang People's Hospital, no. 151 Guangwen Road, Weifang, 260041, China.
J Orthop Surg Res. 2018 Jun 22;13(1):158. doi: 10.1186/s13018-018-0859-1.
This study was performed to compare the clinical outcomes of unicompartmental knee arthroplasty (UKA) revised to total knee arthroplasty (TKA) versus primary TKA.
Relevant trials were identified via a search of the Cochrane Central Register of Controlled Trials and PubMed from inception to 17 June 2017. A meta-analysis was performed to compare postoperative outcomes between revised UKA and primary TKA with respect to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS), mean polyethylene thickness, hospital stay, revision rate, range of motion (ROM), and complications.
Five of 233 studies involving 536 adult patients (revised UKA group, n = 209; primary TKA group, n = 327) were eligible for inclusion in the meta-analysis. The primary TKA group had better WOMAC scores, KSS, and ROM than the revised UKA group (P < 0.05). Compared with primary TKA, revision of UKA to TKA required more augments, stems, and bone grafts and a thicker polyethylene component (P < 0.05). There were no significant differences between the two groups in the revision rate, hospital stay, or complications (P > 0.05).
Conversion of UKA to TKA is associated with poorer clinical outcomes than primary TKA. Furthermore, we believe that conversion of UKA to TKA is more complicated than performing primary TKA. Revision UKA often requires more augments, stems, and bone grafts and thicker polyethylene components than primary TKA. However, patients who undergo conversion of UKA to TKA have similar hospital stay, complications, and revision rate as patients who undergo primary TKA.
本研究旨在比较单髁膝关节置换术（UKA）翻修为全膝关节置换术（TKA）与初次 TKA 的临床疗效。
通过检索 Cochrane 对照试验中心注册库和 PubMed，从建库至 2017 年 6 月 17 日，我们确定了相关试验。我们采用 meta 分析比较了 UKA 翻修为 TKA 与初次 TKA 术后 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）评分、膝关节学会评分（KSS）、平均聚乙烯厚度、住院时间、翻修率、关节活动度（ROM）和并发症等方面的差异。
233 项研究中有 5 项（UKA 翻修组，n=209；初次 TKA 组，n=327）符合纳入标准。与初次 TKA 组相比，UKA 翻修组的 WOMAC 评分、KSS 和 ROM 更差（P<0.05）。与初次 TKA 相比，UKA 翻修为 TKA 需要更多的骨水泥、柄和植骨材料以及更厚的聚乙烯衬垫（P<0.05）。两组在翻修率、住院时间和并发症方面无显著差异（P>0.05）。
UKA 翻修为 TKA 的临床疗效劣于初次 TKA。此外，我们认为 UKA 翻修为 TKA 比初次 TKA 更复杂。UKA 翻修为 TKA 往往需要更多的骨水泥、柄和植骨材料以及更厚的聚乙烯衬垫，而初次 TKA 则不需要。然而，UKA 翻修为 TKA 的患者与初次 TKA 的患者在住院时间、并发症和翻修率方面相似。
