A Comparison of Mobile- and Fixed-Bearing Unicompartmental Knee Arthroplasties in the Treatment of Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis of 1,861 Patients

被引:17
作者
Huang, Fei [1 ]
Wu, Dan [2 ]
Chang, Jun [1 ]
Zhang, Chi [1 ]
Qin, Kunpeng [1 ]
Liao, Faxue [1 ]
Yin, Zongsheng [3 ]
机构
[1] Anhui Med Univ, Dept Orthopaed, Affiliated Hosp 4, Hefei, Anhui, Peoples R China
[2] Anhui Med Univ, Dept Outpatient, Affiliated Hosp 1, Hefei, Anhui, Peoples R China
[3] Anhui Med Univ, Dept Orthopaed, Affiliated Hosp 1, 218 Jixi Rd, Hefei 230000, Anhui, Peoples R China
关键词
unicompartmental knee arthroplasty; osteoarthritis; mobile bearing; fixed bearing; HIGH TIBIAL OSTEOTOMY; FOLLOW-UP; REPLACEMENT; SURVIVORSHIP; PROSTHESIS; ALIGNMENT; OUTCOMES; WEAR;
D O I
10.1055/s-0039-1697901
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Many studies have compared mobile-bearing (MB) and fixed-bearing (FB) unicompartmental knee arthroplasties (UKAs) in patients with unicompartmental knee osteoarthritis (OA). The present systematic review and meta-analysis examined the differences in the clinical and radiological outcomes of MB UKA and FB UKA. PubMed, EMBASE, and Cochrane databases, as well as Google Scholar were searched for relevant studies. Randomized controlled trials (RCTs) and cohort studies that compared MB UKA and FB UKA were included. The weighted mean difference in the knee scores and range of motion (ROM) as well as the summary odds ratio of postoperative mechanical axis alignment, radiolucency, revision rate, and complications were calculated in the MB UKA and FB UKA groups. Finally, 2 RCTs and 11 cohort studies that involved 1,861 patients (1,996 knees) were included. The FB UKA group showed better postoperative Knee Society score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM than the MB UKA group. However, the MB UKA group had more knees with a neutral limb alignment and a lower incidence of polyethylene wear than the FB UKA group. No significant differences were observed between the groups with respect to radiolucency, revision rate, and complications, such as arthritis progression, aseptic loosening, and postoperative pain. This meta-analysis has demonstrated that both prostheses provided excellent clinical outcomes and survivorship in patients with unicompartmental knee OA. The MB UKA group achieved the expected postoperative neutral limb alignment as compared with the FB UKA group, while the FB UKA group showed higher knee scores and superior ROM than the MB UKA group. Limited evidence is currently available; therefore, the results of our meta-analysis should be interpreted with caution.
引用
收藏
页码:434 / 443
页数:10
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