Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Medicine (Baltimore). 2021 Apr 9;100(14):e25240. doi: 10.1097/MD.0000000000025240.
Bilateral unicompartmental knee arthroplasty (UKA) can be divided into one or two stages clinically. Compared with staged bilateral UKA, whether simultaneous bilateral UKA has better clinical efficacy remains to be verified.
PubMed, EBSCO, and Web of Science were searched by us for meta-analysis. Studies were considered eligible for inclusion if they included simultaneous and staged UKA. We excluded studies unrelated to the research question, studies in non-selected languages, and studies where the full-text was not available. The data were extracted by two independent investigators, and disagreements were resolved through discussions with a third party. If important data or information about the content of the paper were not available, authors were contacted. Publication bias in studies has been assessed. Meta-analysis was done using Review Manager 5.3.
The systematic review and meta-analysis identified 3370 trials, of which 8 studies (963 patients) compared simultaneous with staged bilateral UKA. The meta-analysis showed that the clinical outcomes of simultaneous bilateral UKA goes down in operating time (weighted mean difference [WMD] = -19.34, 95% confidence interval [CI] -22.44 to -16.25, P < .00001), postoperative hemoglobin (Std. mean difference [SMD] = -0.46, 95% CI -0.71 to -0.20, P = .0004), length of stay (LOS) (WMD = -4.73, 95% CI -6.39 to -3.06, P < .00001), hospital cost (SMD = -5.42, 95% CI -6.54 to -4.30, P < .00001). There were no significant difference in blood transfusion, venous thrombosis, infection, cardiac complications, pulmonary complications, Oxford Knee Score (OKS) between simultaneous and staged bilateral UKA.
Simultaneous bilateral UKA can effectively reduce the operating time, LOS, and hospital cost without increasing postoperative complications compared to stage bilateral UKA.
CRD42020160056 (www.crd.york.ac.uk/prospero/).
双侧单髁膝关节置换术（UKA）在临床上可分为一期或两期。与分期双侧 UKA 相比，同期双侧 UKA 是否具有更好的临床疗效仍有待验证。
我们通过 PubMed、EBSCO 和 Web of Science 对荟萃分析进行了检索。如果研究包括同期和分期 UKA，则认为符合纳入标准。我们排除了与研究问题无关的研究、未选语言的研究以及无法获取全文的研究。数据由两名独立的研究者提取，如果重要数据或论文内容的信息不可用，则联系作者。评估了研究中的发表偏倚。使用 Review Manager 5.3 进行荟萃分析。
系统评价和荟萃分析共确定了 3370 项试验，其中 8 项研究（963 例患者）比较了同期与分期双侧 UKA。荟萃分析显示，同期双侧 UKA 的手术时间（加权均数差 [WMD] = -19.34，95%置信区间 [CI] -22.44 至 -16.25，P <.00001）、术后血红蛋白（标准均数差 [SMD] = -0.46，95%CI -0.71 至 -0.20，P =.0004）、住院时间（WMD = -4.73，95%CI -6.39 至 -3.06，P <.00001）、住院费用（SMD = -5.42，95%CI -6.54 至 -4.30，P <.00001）均降低。同期和分期双侧 UKA 之间在输血、静脉血栓形成、感染、心脏并发症、肺部并发症、牛津膝关节评分（OKS）方面无显著差异。
与分期双侧 UKA 相比，同期双侧 UKA 可有效缩短手术时间、住院时间和住院费用，而不会增加术后并发症。
CRD42020160056（www.crd.york.ac.uk/prospero/）。
