Moderate evidence supports no difference between unicompartmental knee arthroplasty (UKA) or valgus-producing proximal tibial osteotomy in outcomes and complications in patients with medial compartment knee osteoarthritis.

Rationale
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 three moderate quality studies (Newman 1998, Murray 2014, 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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