Moderate evidence supports that total knee arthroplasty (TKA) could be used to decrease revision surgery risk compared to unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis.

One moderate quality study (Sun 2012) and our meta-analysis of two moderate quality (Sun 2012, Newman 1998) and one low quality (Cameron 1988) studies demonstrated that the rate of revision surgery was significantly higher for those patients with medial compartment OA of the knee treated with unicompartmental arthroplasty, when compared to total knee arthroplasty.

Comparing the data of two moderate quality studies (Newman 1998, Murray 2014) and one low quality study (Cameron 1988) for early complications there were fewer thromboembolic events and manipulations in the unicompartmental when compared to total knee arthroplasty.

One high quality (Stukenborg-Colsman 2001) and two moderate studies (Weidenhielm 1993 and Borjesson 2005) compared the outcomes of UKA and HTO in patients with predominantly medial compartment osteoarthritis. There were no statistically significant differences in complications or outcomes.

There was no data comparing tibial tubercle osteotomy to patellofemoral arthroplasty or total knee arthroplasty. Likewise, there was no data comparing distal femoral osteotomy to lateral compartment unicompartmental arthroplasty or total knee arthroplasty.
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  3. Murray,D.W., MacLennan,G.S., Breeman,S., Dakin,H.A., Johnston,L., Campbell,M.K., Gray,A.M., Fiddian,N., Fitzpatrick,R., Morris,R.W., Grant,A.M. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of different knee prostheses: the Knee Arthroplasty Trial (KAT). Health Technol Assess 2014/3; 19: 1-viii
  4. Newman,J.H., Ackroyd,C.E., Shah,N.A. Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. J Bone Joint Surg Br 1998/9; 5: 862-865
  5. Stukenborg-Colsman,C., Wirth,C.J., Lazovic,D., Wefer,A. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee 2001/10; 3: 187-194
  6. Sun,P.F., Jia,Y.H. Mobile bearing UKA compared to fixed bearing TKA: a randomized prospective study. Knee 2012/3; 2: 103-106
  7. Weidenhielm,L., Olsson,E., Brostrom,L.A., Borjesson-Hederstrom,M., Mattsson,E. Improvement in gait one year after surgery for knee osteoarthrosis: a comparison between high tibial osteotomy and prosthetic replacement in a prospective randomized study. Scand.J Rehabil.Med 1993/3; 1: 25-31