Simultaneous bilateral unicompartmental knee arthroplasty surgery has benefits in low complication rate and cost-effectiveness: A systematic review

Abstract

Importance: Bilateral knee osteoarthritis is frequent and the best choice of treatment remains questionable, especially when the surgeon has to consider simultaneous or staged bilateral unicompartmental knee arthroplasty (UKA). Objective: The purpose of this systematic review was to conduct a systematic review assessing the clinical outcomes associated with simultaneous bilateral and staged bilateral UKA. Evidence review: A literature search was conducted in June 2019 in Medline, PubMed and Embase. A full-text review of eligible studies was conducted by two investigators. Findings: A total of 10 retrospective studies were identified. These studies described the results of simultaneous bilateral UKA compared either to staged bilateral UKA or unilateral UKA. Results showed that the prevalence of mortality at a minimum of 30 days postoperatively, deep vein thrombosis, the rate of blood transfusion and reintervention were not higher in patients undergoing a one-stage bilateral UKA. The cost-effectiveness is in favour of doing a one-stage procedure due to the shortness of total hospital stay. Conclusions and relevance: One-stage simultaneous bilateral UKA can be performed with preventing the postoperative complication, and result in cost savings for patients with symptomatic medial bilateral unicompartmental knee osteoarthritis. Further comparative studies are necessary to determine the best patient profile for such a surgery, and the technical considerations during surgery (consecutive surgery or simultaneous surgery with two operative teams).