International Orthopaedics - 2026-03-19 - Journal Article
Demographics and outcomes of unicondylar knee arthroplasty in Türkiye: a nationwide retrospective database study of eight thousand, five hundred and ninety cases.
Pulatkan A, Yıldız F, Hakyemez ÖS, Birinci M, Akan B, Bingöl İ, Ata N, Birinci Ş, Azboy İ, Tandoğan R, Tuncay İ
Topics
Key Takeaway
In a nationwide Turkish cohort of 8,590 UKA cases, mobile-bearing designs had significantly higher mechanical complication rates (3.8% vs. 1.8%) and revision rates compared to fixed-bearing designs (P<0.001).
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Summary
This nationwide retrospective database study analyzed demographics, complications, and revision rates for 8,590 UKA procedures performed in Türkiye between 2016 and 2022. The overall complication rate was 5.5% and overall revision rate was 4.4% (234/5,377 with revision data available); mobile-bearing designs drove significantly higher mechanical complication rates (3.8% vs. 1.8%) and revision rates versus fixed-bearing designs (P<0.001). Fixation type (cemented vs. cementless) did not influence complication or revision rates, and fixed-bearing implant utilization increased markedly from 18% to 74% between 2018 and 2022.
Key Limitation
Revision rate was calculable for only 5,377 of 8,590 patients with no reported follow-up duration, introducing significant ascertainment bias and precluding meaningful comparison to time-stratified international registry benchmarks.
Original Abstract
BACKGROUND
Favourable long-term clinical and radiological outcomes with low revision and reoperation rates have been reported for unicondylar knee arthroplasty (UKA) in the treatment of end-stage unicompartmental knee osteoarthritis. However, no information on these data is available for the Turkish population. Our aim was to analyze the demographics, indications, outcomes, and revision rates of UKA in Türkiye using a nationwide database.
METHODS
The electronic medical records of 8,590 patients undergoing UKA for unicompartmental osteoarthritis between 2016 and 2022 were retrospectively analyzed. Demographic data of the study population including sex, age, body mass index (BMI), and institution were assessed. The primary outcome measures were complication and revision rates.
RESULTS
Of the 8,590 analyzed patients, 85.2% were women with an average age of 59 ± eight years. The primary indication was osteoarthritis in 7,205 (94.1%) cases. Most patients received cemented implants (78% vs. 22%) and the use of fixed insert designs increased from 18 to 74% between 2018 and 2022. The overall complication rate for the study population was 5.5% (475/8,590). The rate of complications did not differ according to fixation type. However, it was statistically significantly higher in patients who received mobile UKA than the fixed design (3.8% vs. 1.8% for mechanical complications and 1.7% vs. 0.6% for other complications, respectively; P < 0.001). The overall revision rate was 4.4% (234/5,377), with rates being similar for cemented and cementless designs (P = 0.832). However, the revision rate of mobile UKA was significantly higher than that of fixed designs (P < 0.001).
CONCLUSION
The majority of UKAs in Türkiye were cemented implants with an increased usage of fixed bearings over time. Mobile-bearing designs had significantly greater complication and revision rates compared to fixed-bearing implants.