Outcome of simultaneous bi-unicompartmental knee arthroplasty: a systematic review


Ibrahim Akkawi
Maurizio Draghetti
Hassan Zmerly


Bi-unicompartimental knee arthroplasty; Total knee arthroplasty; Unicompartmental knee arthroplasty; Patellofemoral arthroplasty; Osteoarthritis; Clinial outcome


Background and aim: Simultaneous medial and lateral tibiofemoral osteoarthritis (OA) could be treated with bi-unicompartmental knee arthroplasty (Bi-UKA) as an alternative to total knee arthroplasty (TKA). The aim of the present systematic review is to assess if bi-unicompartimental knee arthroplasty (Bi-UKA) is a feasible option for treating medial and lateral tibiofemoral OA.

Materials and Methods: A comprehensive search of PubMed, MEDLINE, Cochrane Library, and Google Scholar was performed to find studies that reported on the outcome of simultaneous Bi-UKA for both medial and lateral tibiofemoral OA.

Results: Seven studies were considered eligible for inclusion in the present systematic review. Intraoperative fractures occurred 8 times. Overall, there were 22 revisions of the prosthetic components for any reason with a survival rate that ranged from 83 to 100%. Of these, 16 revisions were for aseptic loosening of the prosthetic components. Out of 302 surgeries, three were revised due to symptomatic OA progression in the patello-femoral joint . All clinical scores improved at the latest followup compared to preoperative values. Moreover, there were no differences in clinical scores of Bi-UKA compared to unicompartmental knee arthroplasty (UKA), or medial UKA plus patello-femoral prosthesis. Whereas, compared to total knee arthroplasty (TKA), Bi-UKA patients had a comparable or superior scores. Finally, the Bi-UKA group had a significantly shorter hospital stay compared to the TKA group.

Conclusions: The use of Bi-UKA is a valid option to address bicompartmental knee OA in selected patients with low intraopertive fracture rate, low revision rate, statisfactory clinical outcome and fast recovery.


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