• BACKGROUND
    • Surgeons use cementless unicompartmental knee arthroplasty (UKA) as a joint-preserving alternative to total knee arthroplasty (TKA). However, cementless UKA survivorship and revision data remain fragmented. To address this gap, we systematically reviewed (1) survivorship of cementless UKAs reported at time points ≤ five years and ≥ 10 years and (2) the revision indications across implant types.
  • METHODS
    • The PubMed and EMBASE databases were searched to identify relevant studies. Inclusion criteria comprised cementless UKA devices with available survivorship and revision data. Study quality was assessed using the modified Coleman Methodology Score and the Journal of Bone and Joint Surgery Level of Evidence criteria.
  • RESULTS
    • We identified 27 studies on seven cementless device designs. Medial UKAs accounted for most implants (81.5%). Studies with 5-year time points or less reported a median survivorship of 96.1%. At time points ≥ 10 years, survivorship decreased to 92.0% (P = 0.01). The most frequent revision indications included instability (16%), progression of osteoarthritis (14%), and aseptic loosening (11%). In some cases, the indications for revision depended on the device: one device was associated with polyethylene-related complications (57%), while a blade-anchored device was frequently revised following loosening (63%).
  • CONCLUSION
    • Success was device specific, with three of four cementless UKA devices exceeding 95% survivorship within five years and three of five achieving at least 92% survivorship after 10 years. It remains unclear whether cementless UKA devices can decrease revision rates comparable to TKA, promoting increased utilization.