Cementless Unicompartmental Knee Arthroplasty: A Systematic Review of Survivorship and Revision Indications.
Cemile Basgul, Michael A Kurtz, Joshua P Rainey et al.
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In 30 seconds
This systematic review assessed survivorship and revision indications for cementless unicompartmental knee arthroplasty (UKA), drawing on 27 studies of seven device designs; medial UKAs made up 81.5% of implants. Median survivorship was 96.1% at reported time points of five years or less and 92.0% at 10 years or more (P = 0.01). Revision most often followed instability, osteoarthritis progression, or aseptic loosening. Outcomes varied by device, and the review concluded that whether cementless UKA can achieve revision rates comparable to total knee arthroplasty remains unclear.
Key findings
- Median survivorship was 96.1% at time points of five years or less, compared with 92.0% at 10 years or more (P = 0.01).
- The most frequent revision indications were instability (16%), progression of osteoarthritis (14%), and aseptic loosening (11%).
- Three of four devices exceeded 95% survivorship within five years; three of five achieved at least 92% after 10 years.
- Revision indications varied by device: polyethylene-related complications accounted for 57% for one device, while loosening accounted for 63% for a blade-anchored device.
Why it matters
The review brings together survivorship and revision data across cementless UKA designs, showing that outcomes differ by follow-up duration and implant type. These findings help frame discussions of durability and potential failure modes, while underscoring that the available evidence does not establish whether cementless UKA has revision rates comparable to total knee arthroplasty.
What to keep in mind
The review reports fragmented evidence across studies and device designs; the abstract does not provide pooled estimates or details of study quality results.