A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee.
BACKGROUND
The choice of surgical treatments for unicompartmental osteoarthritis (OA) of the knee is still somewhat controversial. Midterm results from cases treated using unicompartmental knee arthroplasty (UKA) or open wedge high tibial osteotomy (OWHTO) were evaluated retrospectively.


METHODS
Twenty-seven knees of 24 patients with varus deformities underwent OWHTO and 30 knees of 18 patients underwent UKA surgeries for the treatment of medial compartmental osteoarthritis (OA). The KSS score, FTA, range of motion and complications were evaluated before and after surgery.


RESULTS
The preoperative mean KSS scores were 49 points in the OWHTO group and 62 in the UKA group which improved postoperatively to 89 (excellent; 19 knees, good; 8 knees), and 88 (excellent; 25, good; 4, fair; 1), respectively. There was no significant difference between the OWHTO and UKA scores. Seventeen patients in the OWHTO group could sit comfortably in the formal Japanese style after surgery. The preoperative mean FTA values for the OWHTO and UKA groups were 182 degrees and 184, and at follow-up measured 169 and 170, respectively. In the UKA group, the femoral component and the polyethylene insertion in one patient was exchanged at 5 years post-surgery and revision TKAs were performed in 2 cases. In the OWHTO group, one tibial plateau fracture and one subcutaneous tissue infection were noted.


CONCLUSIONS
Treatment options should be carefully considered for each OA patient in accordance with their activity levels, grade of advanced OA, age, and range of motion of the knee. OWHTO shows an improved indication for active patients with a good range of motion of the knee.
Takeuchi
Ryohei
R
Department of Orthopaedic Surgery, Yokohama City University, School of Medicine, 3-9 Fukuura Kanazawa-ku Yokohama city, 236-0004, Japan. take0822@hotmail.com.
Umemoto
Yusuke
Y
Aratake
Masato
M
Bito
Haruhiko
H
Saito
Izumi
I
Kumagai
Ken
K
Sasaki
Yohei
Y
Akamatsu
Yasushi
Y
Ishikawa
Hiroyuki
H
Koshino
Tomihisa
T
Saito
Tomoyuki
T
Knee. 2005 Apr;12(2):121-7
15749447
J Arthroplasty. 2003 Aug;18(5):612-8
12934214
Clin Orthop Relat Res. 2007 Nov;464:37-42
17589365
Knee Surg Sports Traumatol Arthrosc. 2008 Nov;16(11):1030-7
18762910
Clin Orthop Relat Res. 1993 Oct;(295):205-13
8403650
Knee. 2001 Oct;8(3):187-94
11706726
J Bone Joint Surg Br. 1972 May;54(2):244-55
5034824
J Arthroplasty. 2005 Aug;20(5):674-9
16310007
Clin Orthop Relat Res. 1991 May;(266):139-44
2019043
Knee. 2002 Sep;9(3):189-96
12126676
Knee. 2004 Dec;11(6):439-44
15581761
Knee Surg Sports Traumatol Arthrosc. 2009 Apr;17(4):382-9
19183959
J Bone Joint Surg Br. 2002 Apr;84(3):351-5
12002491
Knee. 2006 Aug;13(4):296-300
16809040
J Bone Joint Surg Am. 1993 Feb;75(2):196-201
8423180
J Bone Joint Surg Am. 2003 Jan;85(1):78-85
12533576
Ann Rheum Dis. 1993 Jul;52(7):520-6
8346979
Knee Surg Sports Traumatol Arthrosc. 2003 May;11(3):132-8
12774149
J Bone Joint Surg Am. 2000 Jan;82(1):70-9
10653086
Injury. 2003 Nov;34 Suppl 2:B55-62
14580986
J Bone Joint Surg Am. 1987 Mar;69(3):332-54
3818700
Arthritis Rheum. 1968 Dec;11(6):705-33
5700639
J Bone Joint Surg Br. 1986 May;68(3):447-52
3733813
Clin Orthop Relat Res. 1994 May;(302):134-7
8168290
J Bone Joint Surg Am. 1988 Mar;70(3):470-3
3279040
Arthroscopy. 2009 Jan;25(1):46-53
19111218