title: Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review.
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88th Jiefang Road, Hangzhou, 310009, Zhejiang Province, People's Republic of China.
authors.forename: Marcel Budhi
authors.initials: MB
authors.lastname: Santoso
authors.affiliation: Department of Orthopedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88th Jiefang Road, Hangzhou, 310009, Zhejiang Province, People's Republic of China. wulidong@zju.edu.cn.
authors.forename: Lidong
authors.initials: L
authors.lastname: Wu
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000592:standards*; D006801:Humans; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D013977:Tibia / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: High tibial osteotomy (HTO); Meta-analysis; Osteoarthritis; Unicompartmental knee arthroplasty (UKA)