Different surgical treatment modalities for single-compartment knee osteoarthritis: A Bayesian network meta-analysis of randomized controlled trials

Abstract

Abstract Background: The most prevalent chronic joint disease, knee osteoarthritis（KOA）, initially affects only the unilateral compartment and is characterized by secondary bone growth and degenerative changes in the articular cartilage. However, the surgical treatment of single-compartment knee osteoarthritis remains controversial, so we used a network meta-analysis based on Bayesian theory for total knee arthroplasty (TKA),Unicompartmental Knee Arthroplasty (UKA), and high tibia osteotomy（HTO）was evaluated for the efficacy of these three surgical techniques in the treatment of single-compartment knee osteoarthritis. Methods: Pubmed, CNKI, The Cochrane Library databases were searched by computer. Retrieval of randomized controlled trials of TKA, UKA, and HTO for unicompartmental knee osteoarthritis, including studies comparing pairwise and three at the same time, were searched until 7 March 2023. Two independent authors were used for data extraction and literature quality evaluation, and the Knee Society Score(KSS), KSS(functional), revision rate, and complication rate were used as evaluation indicators. Stata, Revman, JAGS, and the gemtc package, which is based on R, were all used to carry out the Bayesian network meta-analysis. Results:After screening, a total of 1438 patients from nine randomized controled trials were included in the analysis. The literature was retrieved from 2158 papers.the SUCRA value of KSS from high to low was: HTO, TKA, UKA, the SUCRA value of KSS(functional) from high to low was:HTO,UKA,TKA,the SUCRA value of the revision rate from low to high: HTO, UKA, TKA, and the SUCRA value of the complication rate from low to high was: HTO, TKA, UKA. Conclusion: Between the three surgical approaches, there were no significant differences in postoperative KSS, KSS (functional), revision rates, or complication rates. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023420516 identifier: CRD42023420516