Summary

The 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 functional outcomes, knee scores, activity levels and complications between the two procedures.

Abstract

The 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 functional outcomes, knee scores, activity levels and complications between the two procedures.

Materials And Methods

This is a prospective, comparative and randomized clinical study carried out on 40 patients split into two groups: OTV and PUC equally. The inclusion criteria were: Medial unicompartmental osteoarthritis, Older age between 50-65 years, BMI less than 30, Axial varus deviation of less 15°, Knee contraction less 10°, Central ligaments integrity, Reducible peripheral laxity , AHLBACK: 2 to 3 and IWANO: from 1 to 2.
Patients were randomized by computer. All osteotomies were performed by closed wedge technique . For the UKA group, all our patients have benefited from a unicompartmental prosthesis with a new generation cemented metal backed prosthesis .
The mean follow-up was 24 months.
The clinical data were analyzed according to the HSS and Oxford scores and the patients had a complete radiological assessment before the intervention and at the last follow-up.

Results

No significant difference between the two groups was noted with regard to free walking (speed), knee scores, deterioration of the contralateral or patellofemoral compartment, nor in the rate of revision by total knee arthroplasty. knee. However, UKA produces better results compared to HTO in terms of functional outcomes, pain assessment and complications, although patients who have undergone HTO tend to have slightly better range of motion.

Discussion

HTO and UKA are the two treatments of choice for unicompartmental medial femoro-tibial knee osteoarthritis. The major advantage of the HTO lies in the fact that no prosthetic material is implanted and that the bone stock is preserved. The disadvantage is to see osteoarthritic degradation appear on the opposite compartment if the deformity is poorly corrected.
In addition, complications are also more frequent after HTO than after hemiarthroplasty.
UKAs provide better functional results and allow faster rehabilitation. Their disadvantages lie in a demanding operating technique for positioning the implants at the risk of seeing rapid degradation of the prosthesis or the opposite compartment.

Conclusion

We believe that both techniques are effective provided that they respect their respective specifications.
Based on our results and analysis of recent studies, UKA appears to be as effective and safe as HTO in the treatment of medial knee osteoarthritis.