Comparison Outcomes of Opening-Wedge High Tibial Osteotomy without Bone Graft and Unicondylar Knee Replacement at 5-year Follow up
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Published:
Oct 15, 2021
Keywords:
Knee Osteoarthritis Osteotomy Arthroplasty Unicompartment
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Abstract
Purpose: The purpose of this study is to compare midterm outcomes of opening-wedge high tibial osteotomy (HTO) without bone graft and unicompartmental arthroplasty (UKA) in advance medial compartment arthritis.
Materials and Methods: Fifty patients were divided into the HTO (n=20) and UKA (n=30) groups. Clinically, we evaluated range of motion, the Oxford knee scoring scale, and Knee Society Score at the five years follow-up postoperatively.
Results: All clinical outcomes gradually improved in both groups from the postoperative period to the final follow-up. At the final follow-up, all clinical outcomes were slightly better in the HTO group than in the UKA group; however, differences were not statistically significant.
Conclusions: HTO is comparable to UKA in terms of clinical outcomes. Thus, the results of this study suggest that HTO might be a good alternative treatment to UKA for medial unicompartmental arthritis.
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References
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2. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980; 62(8): 1329-37.
3. Dettoni F, Maistrelli GL, Rossi P, Castoldi F, Stojimirovich D, Rossi R. UKA versus HTO: clinical results at short term follow up. 75th AAOS Annual Meeting; March 5 - 9, 2008; San Francisco, CA.
4. Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V. Unicondylar knee replacement for primary osteoarthritis: A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007; 78(1): 128-35.
5. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am. 1965; 47: 984-90.
6. Fu D, Li G, Chen K, Zhao Y, Hua Y, Cai Z. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty. 2013; 28(5): 759-65.
7. Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H. The long-term outcome of high tibial osteotomy: a ten-to 20-year follow-up. The Journal of bone and joint surgery British volume. J Bone Joint Surg Br. 2008; 90(5): 592-6.
8. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am. 1979 ; 10(3): 585-608.
9. Zorzi AR, da Silva HGP v, Muszkat C, Marques LC, Cliquet Jr A, de Miranda JB. Opening‐wedge high tibial osteotomy with and without bone graft. Artif Organs. 2011; 35(3): 301-7.
10. Broughton NS, Newman JH, Baily RA. Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5-10 years’ follow-up. J Bone Joint Surg Br. 1986; 68(3): 447-52.
11. Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7–10-year follow-up prospective randomised study. Knee. 2001; 8(3): 187-94.
12. W-Dahl A, Robertsson O, Lidgren L. Surgery for knee osteoarthritis in younger patients: a Swedish Register Study. Acta Orthop. 2010; 81(2): 161-4.
13. Karpman RR, Volz RG. Osteotomy versus unicompartmental prosthetic replacement in the treatment of unicompartmental arthritis of the knee. Orthopedics. 1982; 5(8): 989-91.
14. Yim J-H, Song E-K, Seo H-Y, Kim M-S, Seon J-K. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplasty. 2013; 28(2): 243-7.
15. Jacobi M, Wahl P, Jakob RP. Avoiding intraoperative complications in open-wedge high tibial valgus osteotomy: technical advancement. Knee Surg Sports Traumatol Arthrosc. 2010; 18(2): 200-3.
16. Miller BS, Downie B, McDonough EB, Wojtys EM. Complications after medial opening wedge high tibial osteotomy. Arthroscopy. 2009; 25(6): 639-46.
17. Rodner CM, Adams DJ, Diaz-Doran V, Tate JP, Santangelo SA, Mazzocca AD, et al. Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure. Am J Sports Med. 2006; 34(9): 1431-41.
18. Brouwer RW, Bierma-Zeinstra SMA, van Koeveringe AJ, Verhaar JAN. Patellar height and the inclination of the tibial plateau after high tibial osteotomy: the open versus the closed-wedge technique. J Bone Joint Surg Br. 2005; 87(9): 1227-32.
19. Stoffel K, Willers C, Korshid O, Kuster M. Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study. Knee Surg Sports Traumatol Arthrosc. 2007; 15(9): 1094-100.
20. Barrett WP, Scott RD. Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Joint Surg Am. 1987; 69(9): 1328-35.
21. Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neubauer H, Klinger HM. The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2013; 21(1): 96-112.
2. Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980; 62(8): 1329-37.
3. Dettoni F, Maistrelli GL, Rossi P, Castoldi F, Stojimirovich D, Rossi R. UKA versus HTO: clinical results at short term follow up. 75th AAOS Annual Meeting; March 5 - 9, 2008; San Francisco, CA.
4. Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V. Unicondylar knee replacement for primary osteoarthritis: A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007; 78(1): 128-35.
5. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am. 1965; 47: 984-90.
6. Fu D, Li G, Chen K, Zhao Y, Hua Y, Cai Z. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty. 2013; 28(5): 759-65.
7. Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H. The long-term outcome of high tibial osteotomy: a ten-to 20-year follow-up. The Journal of bone and joint surgery British volume. J Bone Joint Surg Br. 2008; 90(5): 592-6.
8. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am. 1979 ; 10(3): 585-608.
9. Zorzi AR, da Silva HGP v, Muszkat C, Marques LC, Cliquet Jr A, de Miranda JB. Opening‐wedge high tibial osteotomy with and without bone graft. Artif Organs. 2011; 35(3): 301-7.
10. Broughton NS, Newman JH, Baily RA. Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5-10 years’ follow-up. J Bone Joint Surg Br. 1986; 68(3): 447-52.
11. Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7–10-year follow-up prospective randomised study. Knee. 2001; 8(3): 187-94.
12. W-Dahl A, Robertsson O, Lidgren L. Surgery for knee osteoarthritis in younger patients: a Swedish Register Study. Acta Orthop. 2010; 81(2): 161-4.
13. Karpman RR, Volz RG. Osteotomy versus unicompartmental prosthetic replacement in the treatment of unicompartmental arthritis of the knee. Orthopedics. 1982; 5(8): 989-91.
14. Yim J-H, Song E-K, Seo H-Y, Kim M-S, Seon J-K. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplasty. 2013; 28(2): 243-7.
15. Jacobi M, Wahl P, Jakob RP. Avoiding intraoperative complications in open-wedge high tibial valgus osteotomy: technical advancement. Knee Surg Sports Traumatol Arthrosc. 2010; 18(2): 200-3.
16. Miller BS, Downie B, McDonough EB, Wojtys EM. Complications after medial opening wedge high tibial osteotomy. Arthroscopy. 2009; 25(6): 639-46.
17. Rodner CM, Adams DJ, Diaz-Doran V, Tate JP, Santangelo SA, Mazzocca AD, et al. Medial opening wedge tibial osteotomy and the sagittal plane: the effect of increasing tibial slope on tibiofemoral contact pressure. Am J Sports Med. 2006; 34(9): 1431-41.
18. Brouwer RW, Bierma-Zeinstra SMA, van Koeveringe AJ, Verhaar JAN. Patellar height and the inclination of the tibial plateau after high tibial osteotomy: the open versus the closed-wedge technique. J Bone Joint Surg Br. 2005; 87(9): 1227-32.
19. Stoffel K, Willers C, Korshid O, Kuster M. Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study. Knee Surg Sports Traumatol Arthrosc. 2007; 15(9): 1094-100.
20. Barrett WP, Scott RD. Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Joint Surg Am. 1987; 69(9): 1328-35.
21. Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neubauer H, Klinger HM. The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2013; 21(1): 96-112.