Combined partial knee arthroplasty versus total knee arthroplasty: A systematic review and meta-analysis of randomised control trials

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI:10.1016/j.jor.2026.02.018

Raven Joseph , Chinmay Tijare , Khalis Boksh , Arijit Ghosh , Amit Bishnoi , Muhammad Tawfiq Korim , Randeep Aujla

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引用次数: 0

Abstract

Purpose

Total knee arthroplasty (TKA), the standard surgical treatment for knee osteoarthritis (OA) which resurfaces all three compartments, has disadvantages including inferior kinematics and high patient dissatisfaction rates. Combined Partial Knee Arthroplasty (CPKA), which encompasses Bicompartmental knee arthroplasty (BCA) and Bi-unicompartmental knee arthroplasty (Bi-UKA), is a tissue-sparing alternative for patients with bicompartmental disease. High quality evidence is limited, therefore this systematic review and meta-analysis aims to synthesise randomised controlled trial (RCT) data comparing outcomes and complications between BCA or Bi-UKA and TKA.

Methods

A systematic review and meta-analysis were conducted following PRISMA guidelines, searching Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews from inception to July 14, 2025. RCTs comparing CPKA with TKA were included. Seven publications (four unique RCTs) were selected: four comparing BCA-M (medial) to TKA and three comparing Bi-UKA to TKA. Data on patient-reported outcome measures (PROMs), range of motion (ROM), functional tests and complications were extracted and analysed. A random-effects model was used for meta-analysis of revision risk.

Results

TKA showed a statistically significant advantage compared to Bi-UKA in the total and clinical New Knee Society Score (NKSS) at two years. BCA-M patients had superior ROM but an increased incidence of patellar subluxation and meta-analysis found a significantly higher risk of revision compared with TKA (RR 1.75, 95% CI 1.17–2.61, p = 0.007). No other significant differences in PROMs, functional tests or gait analysis were identified.

Conclusions

Outcomes of CPKA are comparable to TKA with few statistically significant differences. While BCA-M showed a greater postoperative ROM, there was a higher incidence of patellar subluxation and meta-analysis found a higher risk of revision. However, current evidence is limited therefore larger long-term RCTs are needed to define the role of CPKA in managing bicompartmental knee OA.

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联合部分膝关节置换术与全膝关节置换术：随机对照试验的系统回顾和荟萃分析

目的全膝关节置换术（TKA）是膝关节骨性关节炎（OA）的标准手术治疗方法，其缺点包括运动学差和患者不满意率高。联合部分膝关节置换术（CPKA），包括双腔室膝关节置换术（BCA）和双单腔室膝关节置换术（Bi-UKA），是双腔室疾病患者的一种保留组织的替代方法。高质量的证据有限，因此本系统综述和荟萃分析旨在综合随机对照试验（RCT）数据，比较BCA或Bi-UKA和TKA的结果和并发症。方法按照PRISMA指南，检索Medline、Embase、Cochrane Central Register of Controlled Trials （Central）和Cochrane Database of systematic Reviews（2025年7月14日），进行系统评价和荟萃分析。纳入比较CPKA与TKA的随机对照试验。选择了7篇出版物（4篇独特的随机对照试验）：4篇比较BCA-M（医学）与TKA， 3篇比较Bi-UKA与TKA。提取并分析了患者报告的结果测量（PROMs）、活动范围（ROM）、功能测试和并发症的数据。采用随机效应模型对修订风险进行meta分析。结果与Bi-UKA相比，stka在2年的总新膝关节社会评分（NKSS）和临床新膝关节社会评分（NKSS）方面具有统计学上的显著优势。BCA-M患者有更好的ROM，但髌骨半脱位的发生率增加，荟萃分析发现与TKA相比，翻修的风险明显更高（RR 1.75, 95% CI 1.17-2.61, p = 0.007）。在PROMs、功能测试或步态分析方面没有发现其他显著差异。结论CPKA与TKA疗效相当，差异无统计学意义。虽然BCA-M术后ROM更大，但髌骨半脱位的发生率更高，荟萃分析发现翻修的风险更高。然而，目前的证据有限，因此需要更大的长期随机对照试验来确定CPKA在治疗双室膝关节OA中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.