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Better clinical outcomes after unicompartmental knee arthroplasty when comparing with high tibial osteotomy.

Abstract Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are well-established treatments for medial knee osteoarthritis (OA). However, it is unclear whether HTO or UKA leads to better clinical outcomes and lower complication rates. This meta-analysis compared the clinical outcomes and complications of HTO and UKA in patients with medial knee OA.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390376
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Better clinical outcomes after unicompartmental knee arthroplasty when comparing 
      with high tibial osteotomy.
PG  - e9268
LID - 10.1097/MD.0000000000009268 [doi]
AB  - BACKGROUND: Both high tibial osteotomy (HTO) and unicompartmental knee
      arthroplasty (UKA) are well-established treatments for medial knee osteoarthritis
      (OA). However, it is unclear whether HTO or UKA leads to better clinical outcomes
      and lower complication rates. This meta-analysis compared the clinical outcomes
      and complications of HTO and UKA in patients with medial knee OA. METHODS: All
      studies comparing the functional outcome, postoperative pain, revision rate to
      total knee arthroplasty (TKA), postoperative complications, postoperative
      velocity, and postoperative range of motion (ROM) as assessed with various
      measurement tools in patients with medial knee OA treated with HTO or UKA were
      included. RESULTS: Sixteen studies were included in the meta-analysis. The
      proportion of patients who underwent revision to TKA (OR 1.56, 95% CI: 0.61-3.98;
      P = .35) did not differ significantly between HTO and UKA. In contrast,
      functional outcome (OR 0.47, 95% CI: 0.24 to 0.95; P = .04), postoperative pain
      (OR 0.28, 95% CI: 0.12 to 0.62; P = .002), postoperative complications (OR 2.48, 
      95% CI: 1.26 to 4.90; P = .009), postoperative velocity (95% CI: -0.11 to -0.00; 
      P = .03), and postoperative ROM (95% CI: 2.02 to 15.23; P = .01) were
      significantly different between the 2 groups. CONCLUSIONS: There were no
      significant differences in the revision rate to TKA between HTO and UKA. However,
      results from subgroup analyses suggested that opening-wedge HTO resulted in a
      lower revision rate to TKA than did UKA, whereas closing-wedge HTO resulted in a 
      higher revision rate to TKA than did UKA. In addition, UKA resulted in
      significantly better functional outcomes and postoperative velocity, along with
      less postoperative pain, fewer postoperative complications, and lower
      postoperative ROM. Based on the findings of current meta-analysis, UKA appears to
      be as efficacious and safe as HTO in the treatment of medial knee OA.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Han, Seung-Beom
AU  - Han SB
AD  - Department of Orthopedic Surgery, Korea University Anam Hospital, Korea
      University College of Medicine, Seoul.
FAU - Kyung, Hee-Soo
AU  - Kyung HS
AD  - Department of Orthopedic Surgery, School of Medicine, Kyungpook National
      University, Daegu.
FAU - Seo, In-Wook
AU  - Seo IW
AD  - Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, 
      Korea.
FAU - Shin, Young-Soo
AU  - Shin YS
AD  - Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, 
      Korea.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - Humans
MH  - Osteoarthritis, Knee/*surgery
MH  - Osteotomy/*methods
MH  - Range of Motion, Articular
MH  - Reoperation
MH  - Tibia/*surgery
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009268 [doi]
AID - 00005792-201712150-00126 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e9268. doi: 10.1097/MD.0000000000009268.