Total Knee Arthroplasty Is Superior to Open Wedge High Tibial Osteotomy in Terms of Pain Relief for Patients With Osteoarthritis

Abstract

Background: Globally, total knee arthroplasty (TKA) is widely performed on patients with osteoarthritis. Meanwhile, open wedge high tibial osteotomy (OWHTO) has garnered attention in our country as a jointpreserving procedure. This study aimed to retrospectively compare the postoperative clinical outcomes of TKA and OWHTO for patients with osteoarthritis. Methods: We selected 94 patients (106 knees) who underwent OWHTO or TKA between 2013 and 2018, had complete clinical data, and were followed up for >2 years. Patients were classified into 2 groups depending on the procedure (TKA: n ¼ 49; OWHTO: n ¼ 45). Patients in the A (¼ arthroplasty) group were significantly older, with a worse range of motion (ROM) than those in the O (osteotomy) group. There were no significant differences regarding sex and body mass index between groups. Operative time, perioperative blood loss, knee ROM, and Japanese Knee Injury and Osteoarthritis Outcome Score (J-KOOS) were compared between the groups. Results: Significant differences were found between the A and O groups regarding operative time (120 ± 27.2 vs 80.3 ± 23.3 minutes), perioperative blood loss (505.4 ± 271.8 vs 322.6 ± 196.1 mL), knee ROM (flexion; 123.4 ± 16.3 vs 133.7 ± 12.8 ), and J-KOOS for pain (87.4 ± 12.5 vs 78.1 ± 15.2 points) and symptoms (86.6 ± 12.3 vs 79.1 ± 13.3 points). There were no significant differences regarding other J-KOOS subscales. Conclusions: OWHTO involved shorter operative times and less blood loss. However, the O group reported less pain relief. The A group represents an older, likely less active patient population. Therefore, OWHTO is a possible joint-preserving treatment options in younger active patients who may not be interested in arthroplasty.

Polydactyly-derived allogeneic chondrocyte cell-sheet transplantation with high tibial osteotomy as regenerative therapy for knee osteoarthritis

“…Previously, we compared clinical outcomes between patients undergoing OWHTO and total knee arthroplasty (TKA). In these patients, the KOOS was lower in patients who underwent OWHTO than in those who received TKA, and residual symptoms such as knee grinding, clicking, and stiffness were worse after OWHTO than after TKA 28 . On this point, in the current study, we confirmed that regeneration of hyaline cartilage had occurred after PD sheet transplantation combined with OWHTO.…”