Zhang Rongwei, Shen Xianyue, Yan Kangyong, Zhang Xianzuo, Zhu Chen
Department of Orthopedics, Centre for Leading Medicine and Advanced Technologies of IHM, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China.
J Orthop Surg Res. 2025 Mar 5;20(1):237. doi: 10.1186/s13018-024-05384-6.
This study was aimed at comparing the efficacy and safety of bicompartmental knee arthroplasty (BKA) and total knee arthroplasty (TKA) in treating bicompartmental knee osteoarthritis through a systematic evaluation and meta-analysis.
A comprehensive systematic literature search of the Pub Med, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases was performed to identify the relevant scientific literature published until 1st March 2024. The eligible studies were evaluated for quality assessment and data extraction, and meta-analysis was performed using Review Manager 4.1 software.
A total of 1378 studies were identified. Based on strict inclusion criteria, 12 studies were finally included in this meta-analysis. The results of the analysis revealed that BKA yielded better postoperative outcomes than TKA, in terms of Knee Society Score (KSS) Knee Score, Function Score, and range of knee flexion (P = 0.02; P < 0.0001; P = 0.0005, respectively). Intraoperative bleeding in the BKA group was significantly lower than that in the TKA group (P = 0.02), although postoperative complications (P < 0.05) were higher and operative time (P = 0.04) was longer in the BKA group. However, the two groups did not show any significant difference in terms of Oxford knee score and WOMAC pain score (P = 0.53 and P = 0.96, respectively).
Our present results indicate that while BKA affords better improvement in knee function and quality of life in bicompartmental knee osteoarthritis than TKA, it also increases complications and operative time. Therefore, further studies are warranted to confirm these results and assess long-term outcomes and cost-effectiveness.
Systematic review registration PROSPERO CRD420-24551418.
本研究旨在通过系统评价和荟萃分析，比较双髁膝关节置换术（BKA）和全膝关节置换术（TKA）治疗双髁膝关节骨关节炎的疗效和安全性。
对PubMed、Embase、Web of Science、Cochrane图书馆和ClinicalTrials.gov数据库进行全面的系统文献检索，以识别截至2024年3月1日发表的相关科学文献。对符合条件的研究进行质量评估和数据提取，并使用Review Manager 4.1软件进行荟萃分析。
共识别出1378项研究。基于严格的纳入标准，本荟萃分析最终纳入12项研究。分析结果显示，在膝关节协会评分（KSS）的膝关节评分、功能评分和膝关节屈曲范围方面，BKA术后效果优于TKA（分别为P = 0.02；P < 0.0001；P = 0.0005）。BKA组术中出血量显著低于TKA组（P = 0.02），尽管BKA组术后并发症较高（P < 0.05）且手术时间较长（P = 0.04）。然而，两组在牛津膝关节评分和WOMAC疼痛评分方面无显著差异（分别为P = 0.53和P = 0.96）。
我们目前的结果表明，虽然BKA在双髁膝关节骨关节炎的膝关节功能和生活质量改善方面优于TKA，但它也增加了并发症和手术时间。因此，有必要进一步研究以证实这些结果，并评估长期疗效和成本效益。
系统评价注册PROSPERO CRD420 - 24551418。
