Research progress of failure and revision of unicompartmental knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GUO Shuxin , GUAN Shikun ,  LIU Ning

Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150001, P. R. China;

Corresponding?author：

LIU Ning, Email: drliuning@163.com

Keywords：

Unicompartmental knee arthroplasty; revision; total knee arthroplasty; osteoarthritis

DOI：

10.7507/1002-1892.202211013

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To conclude the failure factors of unicompartmental knee arthroplasty (UKA), and summarize the research progress of revision surgery. Methods The literature on UKA at home and abroad in recent years was reviewed to summarize its risk factors, treatment methods, including the evaluation of bone loss, prosthesis selection, and surgical techniques. Results The factors inducing UKA failure mainly include improper indications, technical errors, and others. The application of digital orthopedic technology can reduce failures caused by surgical technical errors and shorten the learning curve. There are a variety of options for revision surgery after UKA failure, including polyethylene liner replacement, revision with UKA or total knee arthroplasty, with adequate preoperative evaluation prior to implementation. The biggest challenge in revision surgery is the management and reconstruction of bone defects. Conclusion There is a risk of failure in UKA, which needs to be treated with caution and should be determined according to the type of failure.

Citation： GUO Shuxin, GUAN Shikun, LIU Ning. Research progress of failure and revision of unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(2): 221-227. doi: 10.7507/1002-1892.202211013 Copy

1.	陶可, 林劍浩, 李虎. 單髁關節置換術治療膝骨關節炎的研究進展. 中華骨與關節外科雜志, 2019, 12(2): 150-155.
2.	Hansen EN, Ong KL, Lau E, et al. Unicondylar knee arthroplasty in the U. S. patient population: Prevalence and epidemiology. Am J Orthop (Belle Mead NJ), 2018, 47(12). doi: 10.12788/ajo.2018.0113.
3.	Hansen EN, Ong KL, Lau E, et al. Unicondylar knee arthroplasty has fewer complications but higher revision rates than total knee arthroplasty in a study of large United States databases. J Arthroplasty, 2019, 34(8): 1617-1625.
4.	Johal S, Nakano N, Baxter M, et al. Unicompartmental knee arthroplasty: The past, current controversies, and future perspectives. J Knee Surg, 2018, 31(10): 992-998.
5.	Liddle AD, Pandit H, Judge A, et al. Optimal usage of unicompartmental knee arthroplasty: a study of 41, 986 cases from the National Joint Registry for England and Wales. Bone Joint J, 2015, 97-B(11): 1506-1511.
6.	Moore DM, Sheridan GA, Welch-Phillips A, et al. Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre. Knee Surg Sports Traumatol Arthrosc, 2022, 30(9): 3215-3219.
7.	Mohammad HR, Strickland L, Hamilton TW, et al. Long-term outcomes of over 8, 000 medial Oxford Phase 3 Unicompartmental Knees-a systematic review. Acta Orthop, 2018, 89(1): 101-107.
8.	艾奇, 胡佩巖, 何名江, 等. 活動平臺單髁置換術治療膝關節內側間室骨關節炎的中長期隨訪. 中國中醫骨傷科雜志, 2022, 30(7): 11-14.
9.	van der List JP, Zuiderbaan HA, Pearle AD. Why do medial unicompartmental knee arthroplasties fail today? J Arthroplasty, 2016, 31(5): 1016-1021.
10.	Rodríguez-Merchán EC, Gómez-Cardero P. Unicompartmental knee arthroplasty: Current indications, technical issues and results. EFORT Open Rev, 2018, 3(6): 363-373.
11.	馮重陽, 姬振偉, 吳鵬, 等. 膝關節單髁置換術的研究進展. 實用骨科雜志, 2022, 28(6): 528-532.
12.	Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.
13.	Streit MR, Streit J, Walker T, et al. Minimally invasive Oxford medial unicompartmental knee arthroplasty in young patients. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 660-668.
14.	Musbahi O, Hamilton TW, Crellin AJ, et al. The effect of obesity on revision rate in unicompartmental knee arthroplasty: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3467-3477.
15.	Mancuso F, Hamilton TW, Kumar V, et al. Clinical outcome after UKA and HTO in ACL deficiency: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2016, 24(1): 112-122.
16.	Guo W, Wan T, Tan H, et al. Anterior cruciate ligament deficiency versus intactness for outcomes in patients after unicompartmental knee arthroplasty: a systematic review and meta-analysis. Front Bioeng Biotechnol, 2022, 10: 890118. doi: 10.3389/fbioe.2022.890118.
17.	Volpin A, Kini SG, Meuffels DE. Satisfactory outcomes following combined unicompartmental knee replacement and anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2018, 26(9): 2594-2601.
18.	胥伯勇, 紀保超, 郭文濤, 等. 術前髕股關節退變對Oxford膝關節內側單髁置換術療效的影響. 中華外科雜志, 2017, 55(6): 416-422.
19.	安帥, 馮明利, 李征, 等. 外側髕股關節退變對膝關節內側牛津活動平臺單髁置換術療效的影響. 中華外科雜志, 2020, 58(6): 441-446.
20.	Zhang Q, Zhang Q, Guo W, et al. The learning curve for minimally invasive Oxford phase 3 unicompartmental knee arthroplasty: cumulative summation test for learning curve (LC-CUSUM). J Orthop Surg Res, 2014, 9: 81. doi: 10.1186/s13018-014-0081-8.
21.	Arias-de la Torre J, Valderas JM, Evans JP, et al. Differences in risk of revision and mortality between total and unicompartmental knee arthroplasty. The influence of hospital volume. J Arthroplasty, 2019, 34(5): 865-871.
22.	姚堅, 丁海. 計算機導航及機器人技術輔助膝關節單髁置換術的研究進展. 中國修復重建外科雜志, 2017, 31(1): 110-115.
23.	Batailler C, White N, Ranaldi FM, et al. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1232-1240.
24.	Chowdhry M, Khakha RS, Norris M, et al. Improved survival of computer-assisted unicompartmental knee arthroplasty: 252 cases with a minimum follow-up of 5 years. J Arthroplasty, 2017, 32(4): 1132-1136.
25.	Sanz-Ruiz P, Matas-Diez JA, Carbo-Laso E, et al. Patient-specific instrument can improve functional and radiographic results during learning curve for Oxford unicompartmental knee arthroplasty. J Knee Surg, 2019, 32(2): 180-185.
26.	Tay ML, McGlashan SR, Monk AP, et al. Revision indications for medial unicompartmental knee arthroplasty: a systematic review. Arch Orthop Trauma Surg, 2022, 142(2): 301-314.
27.	Tay ML, Young SW, Frampton CM, et al. The lifetime revision risk of unicompartmental knee arthroplasty. Bone Joint J, 2022, 104-B(6): 672-679.
28.	Ji JH, Park SE, Song IS, et al. Complications of medial unicompartmental knee arthroplasty. Clin Orthop Surg, 2014, 6(4): 365-372.
29.	Saragaglia D, Bonnin M, Dejour D, et al. Results of a French multicentre retrospective experience with four hundred and eighteen failed unicondylar knee arthroplasties. Int Orthop, 2013, 37(7): 1273-1278.
30.	Barrett MC, Wilkinson FO, Blom AW, et al. Incidence, temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96, 294 knees. Knee, 2021, 31: 28-38.
31.	Pegg EC, Walter J, Mellon SJ, et al. Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement. J Orthop Res, 2013, 31(5): 821-828.
32.	Wang WJ, Sun MH, Palmer J, et al. Patterns of compartment involvement in end-stage knee osteoarthritis in a Chinese Orthopedic Center: Implications for implant choice. Orthop Surg, 2018, 10(3): 227-234.
33.	Slaven SE, Cody JP, Sershon RA, et al. The impact of coronal alignment on revision in medial fixed-bearing unicompartmental knee arthroplasty. J Arthroplasty, 2020, 35(2): 353-357.
34.	Hunter DJ, Zhang W, Conaghan PG, et al. Systematic review of the concurrent and predictive validity of MRI biomarkers in OA. Osteoarthritis Cartilage, 2011, 19(5): 557-588.
35.	Baker PN, Petheram T, Avery PJ, et al. Revision for unexplained pain following unicompartmental and total knee replacement. J Bone Joint Surg (Am), 2012, 94(17): e126. doi: 10.2106/JBJS.K.00791.
36.	Kerens B, Boonen B, Schotanus MG, et al. Revision from unicompartmental to total knee replacement: the clinical outcome depends on reason for revision. Bone Joint J, 2013, 95-B(9): 1204-1208.
37.	Barbera JP, Xiao RC, Williams CS, et al. Treatment patterns and failure rates associated with prosthetic joint infection in unicompartmental knee arthroplasty: A systematic review. J Orthop, 2022, 34: 288-294.
38.	Yamagami R, Inui H, Jo T, et al. Unicompartmental knee arthroplasty is associated with lower proportions of surgical site infection compared with total knee arthroplasty: A retrospective nationwide database study. Knee, 2021, 28: 124-130.
39.	Bae JH, Kim JG, Lee SY, et al. Epidemiology of bearing dislocations after mobile-bearing unicompartmental knee arthroplasty: Multicenter analysis of 67 bearing dislocations. J Arthroplasty, 2020, 35(1): 265-271.
40.	Suzuki T, Ryu K, Kojima K, et al. The effect of posterior tibial slope on joint gap and range of knee motion in mobile-bearing unicompartmental knee arthroplasty. J Arthroplasty, 2019, 34(12): 2909-2913.
41.	Li C, Li T, Zhang Z, et al. Potential factors in postoperative dislocation of Oxford phase Ⅲ mobile bearing UKA in Chinese patients: a single-center retrospective study. BMC Musculoskelet Disord, 2021, 22(1): 930. doi: 10.1186/s12891-021-04828-y.
42.	Akagi M, Moritake A, Yamagishi K, et al. Referencing the tibial plateau with a probe improves the accuracy of the posterior slope in medial unicompartmental knee arthroplasty. Arthroplast Today, 2022, 18: 89-94.
43.	Mohammad HR, Bullock GS, Kennedy JA, et al. Cementless unicompartmental knee replacement achieves better ten-year clinical outcomes than cemented: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3229-3245.
44.	Yokoyama M, Nakamura Y, Egusa M, et al. Factors related to stress fracture after unicompartmental knee arthroplasty. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2018, 15: 1-5.
45.	蘆升升, 張潤杰, 劉澤, 等. 脛骨平臺后傾角在保膝治療中的研究進展. 實用骨科雜志, 2020, 26(11): 1006-1009.
46.	Hung YW, Fan JCH, Kwok CKB, et al. Delayed tibial-platform periprosthetic stress fracture after unicompartmental knee arthroplasty: Uncommon and devastating complication. Journal of Orthopaedics, Trauma and Rehabilitation, 2018, 25(1): 29-33.
47.	Springer BD, Scott RD, Thornhill TS. Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res, 2006, 446: 214. doi: 10.1097/01.blo.0000214431.19033.fa-220.
48.	Vasso M, Corona K, D’Apolito R, et al. Unicompartmental knee arthroplasty: Modes of failure and conversion to total knee arthroplasty. Joints, 2017, 5(1): 44-50.
49.	Cao Z, Niu C, Gong C, et al. Comparison of fixed-bearing and mobile-bearing unicompartmental knee arthroplasty: A systematic review and meta-analysis. J Arthroplasty, 2019, 34(12): 3114-3123.
50.	Sun X, Liu P, Lu F, et al. Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis. J Orthop Surg Res, 2021, 16(1): 28. doi: 10.1186/s13018-020-02190-8.
51.	Kang SW, Kim KT, Hwang YS, et al. Is mobile-bearing medial unicompartmental knee arthroplasty appropriate for Asian patients with the risk of bearing dislocation? J Arthroplasty, 2020, 35(5): 1222-1227.
52.	Sabah SA, Lim CT, Middleton R, et al. Management of aseptic failure of the mobile-bearing Oxford unicompartmental knee arthroplasty. Knee, 2020, 27(6): 1721-1728.
53.	Di Martino A, Bordini B, Barile F, et al. Unicompartmental knee arthroplasty has higher revisions than total knee arthroplasty at long term follow-up: a registry study on 6453 prostheses. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3323-3329.
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1. 陶可, 林劍浩, 李虎. 單髁關節置換術治療膝骨關節炎的研究進展. 中華骨與關節外科雜志, 2019, 12(2): 150-155.
2. Hansen EN, Ong KL, Lau E, et al. Unicondylar knee arthroplasty in the U. S. patient population: Prevalence and epidemiology. Am J Orthop (Belle Mead NJ), 2018, 47(12). doi: 10.12788/ajo.2018.0113.
3. Hansen EN, Ong KL, Lau E, et al. Unicondylar knee arthroplasty has fewer complications but higher revision rates than total knee arthroplasty in a study of large United States databases. J Arthroplasty, 2019, 34(8): 1617-1625.
4. Johal S, Nakano N, Baxter M, et al. Unicompartmental knee arthroplasty: The past, current controversies, and future perspectives. J Knee Surg, 2018, 31(10): 992-998.
5. Liddle AD, Pandit H, Judge A, et al. Optimal usage of unicompartmental knee arthroplasty: a study of 41, 986 cases from the National Joint Registry for England and Wales. Bone Joint J, 2015, 97-B(11): 1506-1511.
6. Moore DM, Sheridan GA, Welch-Phillips A, et al. Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre. Knee Surg Sports Traumatol Arthrosc, 2022, 30(9): 3215-3219.
7. Mohammad HR, Strickland L, Hamilton TW, et al. Long-term outcomes of over 8, 000 medial Oxford Phase 3 Unicompartmental Knees-a systematic review. Acta Orthop, 2018, 89(1): 101-107.
8. 艾奇, 胡佩巖, 何名江, 等. 活動平臺單髁置換術治療膝關節內側間室骨關節炎的中長期隨訪. 中國中醫骨傷科雜志, 2022, 30(7): 11-14.
9. van der List JP, Zuiderbaan HA, Pearle AD. Why do medial unicompartmental knee arthroplasties fail today? J Arthroplasty, 2016, 31(5): 1016-1021.
10. Rodríguez-Merchán EC, Gómez-Cardero P. Unicompartmental knee arthroplasty: Current indications, technical issues and results. EFORT Open Rev, 2018, 3(6): 363-373.
11. 馮重陽, 姬振偉, 吳鵬, 等. 膝關節單髁置換術的研究進展. 實用骨科雜志, 2022, 28(6): 528-532.
12. Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.
13. Streit MR, Streit J, Walker T, et al. Minimally invasive Oxford medial unicompartmental knee arthroplasty in young patients. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3): 660-668.
14. Musbahi O, Hamilton TW, Crellin AJ, et al. The effect of obesity on revision rate in unicompartmental knee arthroplasty: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3467-3477.
15. Mancuso F, Hamilton TW, Kumar V, et al. Clinical outcome after UKA and HTO in ACL deficiency: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2016, 24(1): 112-122.
16. Guo W, Wan T, Tan H, et al. Anterior cruciate ligament deficiency versus intactness for outcomes in patients after unicompartmental knee arthroplasty: a systematic review and meta-analysis. Front Bioeng Biotechnol, 2022, 10: 890118. doi: 10.3389/fbioe.2022.890118.
17. Volpin A, Kini SG, Meuffels DE. Satisfactory outcomes following combined unicompartmental knee replacement and anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2018, 26(9): 2594-2601.
18. 胥伯勇, 紀保超, 郭文濤, 等. 術前髕股關節退變對Oxford膝關節內側單髁置換術療效的影響. 中華外科雜志, 2017, 55(6): 416-422.
19. 安帥, 馮明利, 李征, 等. 外側髕股關節退變對膝關節內側牛津活動平臺單髁置換術療效的影響. 中華外科雜志, 2020, 58(6): 441-446.
20. Zhang Q, Zhang Q, Guo W, et al. The learning curve for minimally invasive Oxford phase 3 unicompartmental knee arthroplasty: cumulative summation test for learning curve (LC-CUSUM). J Orthop Surg Res, 2014, 9: 81. doi: 10.1186/s13018-014-0081-8.
21. Arias-de la Torre J, Valderas JM, Evans JP, et al. Differences in risk of revision and mortality between total and unicompartmental knee arthroplasty. The influence of hospital volume. J Arthroplasty, 2019, 34(5): 865-871.
22. 姚堅, 丁海. 計算機導航及機器人技術輔助膝關節單髁置換術的研究進展. 中國修復重建外科雜志, 2017, 31(1): 110-115.
23. Batailler C, White N, Ranaldi FM, et al. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1232-1240.
24. Chowdhry M, Khakha RS, Norris M, et al. Improved survival of computer-assisted unicompartmental knee arthroplasty: 252 cases with a minimum follow-up of 5 years. J Arthroplasty, 2017, 32(4): 1132-1136.
25. Sanz-Ruiz P, Matas-Diez JA, Carbo-Laso E, et al. Patient-specific instrument can improve functional and radiographic results during learning curve for Oxford unicompartmental knee arthroplasty. J Knee Surg, 2019, 32(2): 180-185.
26. Tay ML, McGlashan SR, Monk AP, et al. Revision indications for medial unicompartmental knee arthroplasty: a systematic review. Arch Orthop Trauma Surg, 2022, 142(2): 301-314.
27. Tay ML, Young SW, Frampton CM, et al. The lifetime revision risk of unicompartmental knee arthroplasty. Bone Joint J, 2022, 104-B(6): 672-679.
28. Ji JH, Park SE, Song IS, et al. Complications of medial unicompartmental knee arthroplasty. Clin Orthop Surg, 2014, 6(4): 365-372.
29. Saragaglia D, Bonnin M, Dejour D, et al. Results of a French multicentre retrospective experience with four hundred and eighteen failed unicondylar knee arthroplasties. Int Orthop, 2013, 37(7): 1273-1278.
30. Barrett MC, Wilkinson FO, Blom AW, et al. Incidence, temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96, 294 knees. Knee, 2021, 31: 28-38.
31. Pegg EC, Walter J, Mellon SJ, et al. Evaluation of factors affecting tibial bone strain after unicompartmental knee replacement. J Orthop Res, 2013, 31(5): 821-828.
32. Wang WJ, Sun MH, Palmer J, et al. Patterns of compartment involvement in end-stage knee osteoarthritis in a Chinese Orthopedic Center: Implications for implant choice. Orthop Surg, 2018, 10(3): 227-234.
33. Slaven SE, Cody JP, Sershon RA, et al. The impact of coronal alignment on revision in medial fixed-bearing unicompartmental knee arthroplasty. J Arthroplasty, 2020, 35(2): 353-357.
34. Hunter DJ, Zhang W, Conaghan PG, et al. Systematic review of the concurrent and predictive validity of MRI biomarkers in OA. Osteoarthritis Cartilage, 2011, 19(5): 557-588.
35. Baker PN, Petheram T, Avery PJ, et al. Revision for unexplained pain following unicompartmental and total knee replacement. J Bone Joint Surg (Am), 2012, 94(17): e126. doi: 10.2106/JBJS.K.00791.
36. Kerens B, Boonen B, Schotanus MG, et al. Revision from unicompartmental to total knee replacement: the clinical outcome depends on reason for revision. Bone Joint J, 2013, 95-B(9): 1204-1208.
37. Barbera JP, Xiao RC, Williams CS, et al. Treatment patterns and failure rates associated with prosthetic joint infection in unicompartmental knee arthroplasty: A systematic review. J Orthop, 2022, 34: 288-294.
38. Yamagami R, Inui H, Jo T, et al. Unicompartmental knee arthroplasty is associated with lower proportions of surgical site infection compared with total knee arthroplasty: A retrospective nationwide database study. Knee, 2021, 28: 124-130.
39. Bae JH, Kim JG, Lee SY, et al. Epidemiology of bearing dislocations after mobile-bearing unicompartmental knee arthroplasty: Multicenter analysis of 67 bearing dislocations. J Arthroplasty, 2020, 35(1): 265-271.
40. Suzuki T, Ryu K, Kojima K, et al. The effect of posterior tibial slope on joint gap and range of knee motion in mobile-bearing unicompartmental knee arthroplasty. J Arthroplasty, 2019, 34(12): 2909-2913.
41. Li C, Li T, Zhang Z, et al. Potential factors in postoperative dislocation of Oxford phase Ⅲ mobile bearing UKA in Chinese patients: a single-center retrospective study. BMC Musculoskelet Disord, 2021, 22(1): 930. doi: 10.1186/s12891-021-04828-y.
42. Akagi M, Moritake A, Yamagishi K, et al. Referencing the tibial plateau with a probe improves the accuracy of the posterior slope in medial unicompartmental knee arthroplasty. Arthroplast Today, 2022, 18: 89-94.
43. Mohammad HR, Bullock GS, Kennedy JA, et al. Cementless unicompartmental knee replacement achieves better ten-year clinical outcomes than cemented: a systematic review. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3229-3245.
44. Yokoyama M, Nakamura Y, Egusa M, et al. Factors related to stress fracture after unicompartmental knee arthroplasty. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2018, 15: 1-5.
45. 蘆升升, 張潤杰, 劉澤, 等. 脛骨平臺后傾角在保膝治療中的研究進展. 實用骨科雜志, 2020, 26(11): 1006-1009.
46. Hung YW, Fan JCH, Kwok CKB, et al. Delayed tibial-platform periprosthetic stress fracture after unicompartmental knee arthroplasty: Uncommon and devastating complication. Journal of Orthopaedics, Trauma and Rehabilitation, 2018, 25(1): 29-33.
47. Springer BD, Scott RD, Thornhill TS. Conversion of failed unicompartmental knee arthroplasty to TKA. Clin Orthop Relat Res, 2006, 446: 214. doi: 10.1097/01.blo.0000214431.19033.fa-220.
48. Vasso M, Corona K, D’Apolito R, et al. Unicompartmental knee arthroplasty: Modes of failure and conversion to total knee arthroplasty. Joints, 2017, 5(1): 44-50.
49. Cao Z, Niu C, Gong C, et al. Comparison of fixed-bearing and mobile-bearing unicompartmental knee arthroplasty: A systematic review and meta-analysis. J Arthroplasty, 2019, 34(12): 3114-3123.
50. Sun X, Liu P, Lu F, et al. Bearing dislocation of mobile bearing unicompartmental knee arthroplasty in East Asian countries: a systematic review with meta-analysis. J Orthop Surg Res, 2021, 16(1): 28. doi: 10.1186/s13018-020-02190-8.
51. Kang SW, Kim KT, Hwang YS, et al. Is mobile-bearing medial unicompartmental knee arthroplasty appropriate for Asian patients with the risk of bearing dislocation? J Arthroplasty, 2020, 35(5): 1222-1227.
52. Sabah SA, Lim CT, Middleton R, et al. Management of aseptic failure of the mobile-bearing Oxford unicompartmental knee arthroplasty. Knee, 2020, 27(6): 1721-1728.
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