Unicompartmental Knee Arthroplasty Provides Higher Activity and Durability Than Valgus-Producing Proximal Tibial Osteotomy at 5 to 7 Years

Krych, Aaron J.; Reardon, Patrick J.; Sousa, Paul L.; Pareek, Ayoosh; Stuart, Michael J.; Pagnano, Mark W.

doi:10.2106/jbjs.15.01031

Cited by 50 publications

(74 citation statements)

References 25 publications

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“…1). Ultimately, 15 studies [5, 8–21] were selected and included in our analysis, of which only 3 were prospective randomized studies (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…Patients’ age ranges were 42.7–71 years and 49.2–80 years, respectively. Only 11 studies [5, 8, 9, 12, 13, 15, 17–21] provided patients’ gender: 195 males and 277 females underwent HTO, whereas 182 males and 374 females underwent UKA. The follow-up period ranged from a minimum of 0.5 years to a maximum of 17 years.…”

Section: Resultsmentioning

confidence: 99%

“…The follow-up period ranged from a minimum of 0.5 years to a maximum of 17 years. Eight studies [5, 12, 13, 15, 17, 19–21] reported the indications for inclusion in the study; these were strictly used for isolated medial knee OA with a varus deformity. The inclusion criteria for the other studies were varied or unclear.…”

Section: Resultsmentioning

confidence: 99%

“…The inclusion criteria for the other studies were varied or unclear. Six papers [5, 12, 13, 15, 18, 20] reported the cohorts using the Ahlbäck OA score, and three papers [9, 17, 21] used the Kellgreen–Lawrence (K/L) score. All of the included studies described the type of procedure, except one [18] in the HTO group and three [8, 16, 18] in the UKA group.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies [5, 12, 13, 15, 17, 19, 21] used various scoring systems to compare knee scores between the two procedures. Although no statistically significant difference was found ( p = 0.11; STD = −0.21; 95% CI = −0.47, 0.05), the UKA group exhibited better functional results.…”

Section: Resultsmentioning

confidence: 99%

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Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Santoso¹,

Wu²

2017

J Orthop Surg Res

114

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Background: Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. Methods: We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a meta-analysis. Results: No significant difference between the two groups was noted with respect to free walking (velocity), knee score, deterioration of the contralateral or patellofemoral knee, or revision rate and total knee arthroplasty. However, UKA produced better outcomes compared to HTO in terms of the functional results, pain assessment, and complications, although patients who underwent HTO tended to have slightly better range of motion. Conclusions: Valgus HTO provides better physical activity for younger patients whereas UKA is more suitable for older patients due to shorter rehabilitation time and faster functional recovery. Although UKA patients tended to have improved overall long-term outcomes, which may be due to accurate indications and patient selection, both treatment options yielded pleasing results. Therefore, we are unable to conclude that either method is superior.

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“…1). Ultimately, 15 studies [5, 8–21] were selected and included in our analysis, of which only 3 were prospective randomized studies (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Santoso¹,

Wu²

2017

J Orthop Surg Res

114

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Opening wedge high tibial osteotomy yields comparable to superior outcomes to unicompartmental knee arthroplasty at 2 years of follow‐up in patients suffering from Ahlbäck III knee osteoarthritis: A propensity score‐matched analysis

Onishi,

Jacquet,

Nakayama

et al. 2024

J. exp. orthop.

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PurposeTo compare the clinical outcomes between opening wedge high tibial osteotomy (OWHTO) and unicompartmental knee arthroplasty (UKA) in patients with Ahlbäck Grade 3 medial compartmental knee osteoarthritis (OA) using a propensity score matching (PSM) analysis.MethodsThis retrospective study included all OWHTO and UKA procedures performed between 2016 and 2021 at a single institution. Inclusion criteria were patients diagnosed with medial knee OA, specifically Ahlbäck Grade 3 arthritis. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Radiographic parameters included hip–knee–ankle (HKA), medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA) and joint line convergence angle (JLCA). Primary outcomes included improvement in clinical scores at 3, 12 and 24 months post‐operatively. Secondary outcomes included radiographic parameters, complication rates and re‐intervention rates. One‐to‐one PSM was conducted based on gender, age and preoperative KOOS pain scores.ResultsAfter evaluating eligibility using PSM, a total of 50 knees in the UKA group and 50 knees in the OWHTO group were included. There was no significant difference between groups in preoperative overall KOOS, but the UKA group had better overall KOOS at 3 months (p < 0.001). However, the overall KOOS at 12 and 24 months were superior in the OWHTO group compared to the UKA group (12 months; 84.6 ± 4.9 vs. 86.4 ± 2.9, p = 0.022, 24 months; 84.9 ± 5.3 vs. 87.0 ± 3.7, p = 0.022). As for post‐operative radiological parameters, HKA, MPTA, LDFA and JLCA were higher in the OWHTO group at 24 months post‐operatively. No significant differences were noted in the rates of complication or re‐intervention between groups.ConclusionsOWHTO can provide outcomes equal to or better than UKA at 24 months post‐operatively in patients with advanced knee OA.Level of EvidenceLevel Ⅲ, Prospective designed retrospective comparative study.

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Return to Sport After Unicondylar, Patellofemoral, and Total Knee Arthroplasty

Noyes

Barber-Westin²,

Heckmann

2019

Return to Sport After ACL Reconstruction and Other Knee Operations

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Unicompartmental Knee Arthroplasty Provides Higher Activity and Durability Than Valgus-Producing Proximal Tibial Osteotomy at 5 to 7 Years

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 50 publications

References 25 publications

Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review

Opening wedge high tibial osteotomy yields comparable to superior outcomes to unicompartmental knee arthroplasty at 2 years of follow‐up in patients suffering from Ahlbäck III knee osteoarthritis: A propensity score‐matched analysis

Return to Sport After Unicondylar, Patellofemoral, and Total Knee Arthroplasty

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