Indications for lateral unicompartmental knee arthroplasty – A systematic review

IF 1.6 4区医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-11-13 DOI:10.1016/j.knee.2024.10.012

Kristine Ifigenia Bunyoz , Anders Troelsen , Kirill Gromov , Abtin Alvand , Nicholas Bottomley , Will Jackson , Andrew Price

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Abstract

Background

While evidence-based indications are established for medial UKA, the optimal indications for lateral UKA have not received as much attention. There exists significant anatomical, osteoarthritis phenotype, kinematic, and surgical technique differences between medial and lateral UKA. The indications for the two procedures may therefore not be identical. Hence, this review aims to access the indications and contraindications in published cohort studies on lateral UKA, to assess if consensus exists.

Methods

In May 2024, a systematic review was carried out following the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort studies on lateral UKA with a clear report of indications were included. Data on indications and contraindications were extracted to evaluate consensus. Furthermore, outcomes related to expanding or testing indications for lateral UKA were obtained.

Results

38 studies were included. Lateral UKA was mostly performed for primary lateral osteoarthritis. The most reported indications were moderate to severe lateral osteoarthritis, with full-thickness cartilage in the medial compartment, intact ligaments, a correctable valgus deformity, and a flexion contracture < 10–15 degrees. The most reported contraindications were inflammatory arthritis and severe patellofemoral involvement. Eight studies investigated different indications on outcomes after lateral UKA; suggesting better outcomes for primary lateral osteoarthritis, no significant impact from the state of the patellofemoral joint, and conflicting results regarding age and weight.

Conclusion

While the literature suggests that some agreement does exist regarding indications for lateral UKA, a strong consensus was not found, indicating that well-defined and consensus-based indications for lateral UKA do not yet exist.

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外侧单室膝关节置换术的适应症 - 系统回顾。

背景：虽然内侧UKA的适应症已得到循证医学的证实，但外侧UKA的最佳适应症却没有得到如此多的关注。内侧和外侧UKA在解剖学、骨关节炎表型、运动学和手术技巧方面存在明显差异。因此，两种手术的适应症可能不尽相同。因此，本综述旨在查阅已发表的有关外侧UKA的队列研究中的适应症和禁忌症，以评估是否存在共识：方法：2024 年 5 月，按照《系统综述和荟萃分析首选报告项目》（Preferred Reporting Item for Systematic Reviews and Meta-Analyses，PRISMA）指南开展了一项系统综述。方法：2024 年 5 月，按照《系统综述和元分析首选报告项目》（PRISMA）指南进行了系统综述，纳入了明确报告适应症的外侧 UKA 队列研究。提取适应症和禁忌症数据以评估共识。此外，还获得了与扩大或测试侧位UKA适应症相关的结果：结果：共纳入 38 项研究。外侧UKA多用于治疗原发性外侧骨关节炎。报道最多的适应症是中度至重度外侧骨关节炎，内侧间室软骨全厚，韧带完好，外翻畸形可矫正，屈曲挛缩结论：外侧UKA的适应症与内侧间室软骨全厚、韧带完好、外翻畸形可矫正、屈曲挛缩等因素有关：虽然文献表明，在外侧UKA的适应症方面存在一些共识，但并未达成强烈的共识，这表明外侧UKA尚不存在定义明确且基于共识的适应症。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.