Comparison Outcomes of Opening-Wedge High Tibial Osteotomy without Bone Graft and Unicondylar Knee Replacement at 5-year Follow up

Authors

  • Pawaris Sungkhun, MD Department of Orthopedic Surgery, Somdejprasangkharach XVII Hospital, Suphan Buri

Keywords:

Knee, Osteoarthritis, Osteotomy, Arthroplasty, Unicompartment

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.

Metrics

Metrics Loading ...

References

Nwachukwu BU, McCormick FM, Schairer WW, Frank RM, Provencher MT, Roche MW. Unicompartmental knee arthroplasty versus high tibial osteotomy: United States practice patterns for the surgical treatment of unicompartmental arthritis. J Arthroplasty. 2014; 29(8): 1586-9.

Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am. 1980; 62(8): 1329-37.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Karpman RR, Volz RG. Osteotomy versus unicompartmental prosthetic replacement in the treatment of unicompartmental arthritis of the knee. Orthopedics. 1982; 5(8): 989-91.

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.

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.

Miller BS, Downie B, McDonough EB, Wojtys EM. Complications after medial opening wedge high tibial osteotomy. Arthroscopy. 2009; 25(6): 639-46.

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.

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.

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.

Barrett WP, Scott RD. Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Joint Surg Am. 1987; 69(9): 1328-35.

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.

Radiography taken before and after undergoing HTO without bone graft

Downloads

Published

2021-10-15

How to Cite

1.
Sungkhun P. Comparison Outcomes of Opening-Wedge High Tibial Osteotomy without Bone Graft and Unicondylar Knee Replacement at 5-year Follow up. JseaOrtho [Internet]. 2021 Oct. 15 [cited 2024 Dec. 22];45(3-4):20-5. Available from: https://jseaortho.org/index.php/jsao/article/view/17

Issue

Section

Original Articles