OTSR - 2026-07-11 - Journal Article; Review
Downhill skiing following medial or lateral unicompartmental knee arthroplasty: a systematic review.
Nicholas PR, Arnold MA, Rankin CS, Bell SW, Brown MJ
Topics
Key Takeaway
Return to downhill skiing after UKA ranges from 0% to 37.5% across five studies, with a consistent trend toward reduced participation despite improved functional outcomes.
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Summary
This PROSPERO-registered systematic review (CRD420261322269) searched PubMed, EMBASE, and Cochrane to evaluate return to downhill skiing after medial or lateral UKA. Five studies met inclusion criteria; return-to-skiing rates ranged from 0% to 37.5% with high heterogeneity and inconsistent outcome reporting. Functional outcomes improved in all studies, but data on time to return, skiing level, and skiing-related complications were insufficient for pooled analysis.
Key Limitation
Only five studies with inconsistent outcome reporting and no poolable data preclude any quantitative conclusions about return rates, timing, or implant survivorship specific to skiers.
Original Abstract
BACKGROUND
Unicompartmental knee arthroplasty (UKA) is increasingly performed in younger and more active patients. Therefore, there are expectations relating to a return-to-sport. Downhill skiing is a physically demanding sport associated with substantial joint loading and risk of injury. There is a lack of high-quality evidence regarding a return to downhill skiing following medial or lateral UKA. This systematic review evaluates the available evidence regarding return to downhill skiing following either medial or lateral UKA.
PATIENTS AND METHODS
This review was prospectively registered on PROSPERO (CRD420261322269). PubMed, EMBASE and Cochrane databases were systematically searched. Included studies reported a return to downhill-skiing following medial or lateral UKA. Studies were screened and data were extracted. The Newcastle-Ottawa Scale was used to assess risk of bias.
RESULTS
Five studies met the inclusion criteria. There was inconsistent reporting of return to downhill skiing following UKA. Return rates ranged from 0% to 37.5%. A trend towards reduced participation in downhill skiing post-operatively was observed across heterogeneous studies. Functional outcomes improved following UKA in all included studies. There was limited data available regarding time to return to skiing, skiing level and skiing-related complications.
DISCUSSION
There is limited evidence regarding return to downhill skiing following medial or lateral UKA. While overall return to sport following UKA is high, there appears to be a decline in downhill skiing post-operatively. Functional outcomes improve following UKA but there is limited evidence relating to implant survivorship and radiographic outcomes. Given the limited evidence base, an individualised approach based on clinician judgement and patient-specific factors appears appropriate.
LEVEL OF EVIDENCE
IV; systematic review of Level IV studies.