Abstract
Unicompartmental knee arthroplasty (UKA), encompassing both medial and lateral approaches,
facilitates accelerated rehabilitation and enhances patient satisfaction in comparison
to total knee arthroplasty (TKA). However, the optimal surgical techniques and implant
positioning continue to be topics of ongoing debate. This study compares the clinical
efficacy and implant survival rates of medial and lateral UKA to inform clinical decision-making
and optimize patient outcomes. A comprehensive literature search was performed across
four major electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library), yielding
peer-reviewed journal articles that met the inclusion criteria. Statistical analysis
involved calculating standardized mean differences (SMDs) and odds ratios (ORs) with
corresponding 95% confidence intervals (CIs). Heterogeneity was evaluated using the
Cochrane Q test and I
2 statistic, with p -values reported accordingly. Data analysis was facilitated using Review Manager (RevMan)
version 5.4. This meta-analysis of 15 studies (n = 36,006 UKA patients) found no significant differences in survival rates, postoperative
pain, and function scores between medial and lateral UKA. Specifically, the long-term
subgroup (>10 years) showed a non-significant higher survival rate for lateral UKA
(OR: 0.99, 95% CI: 0.73–1.32, p = 0.92, I
2 = 51%), while the short- and mid-term subgroup (<10 years) showed a non-significant
higher survival rate for medial UKA (OR: 1.20, 95% CI: 0.96–1.50, p = 0.12, I
2 = 73%). Additionally, the pooled SMD revealed no significant differences in postoperative
pain (SMD: 0.08, 95% CI: −0.27 to 0.44) and functional scores (SMD: 0.23, 95% CI:
−0.05 to 0.51) between the two groups. In conclusion, this systematic review and meta-analysis
found no substantial disparities in clinical outcomes, survival rates, functional
improvement, or pain alleviation between medial and lateral UKAs, confirming both
as viable options.
Keywords knee osteoarthritis - unicondylar knee replacement - unicompartmental knee arthroplasty
(medial/lateral) - implant survival - all-polythene prosthetics - metal-backed prosthetics
- pain score - functional score
