2025 ISAKOS Biennial Congress ePoster
Comparison Of Medial Opening Wedge High Tibial Osteotomy And Unicompartmental Knee Arthroplasty Outcomes In Asian And Western Populations: A Meta-Analysis Of Early Revision To Total Knee Arthroplasty
Zhen Jonathan Liang, MBBS, Singapore SINGAPORE
Hamid Rahmatullah Bin Abd Razak, MBBS, FRCSEd (Ortho), FRCSGlasg (Tr & Orth), FAMS, Singapore SINGAPORE
Kong Hwee Lee, MBBS, FRCS (Ortho), Singapore SINGAPORE
Junwei Soong, MBBS, MRCS (Edin), MMED (Ortho), FRCS (Edin), Singapore SINGAPORE
Singapore General Hospital, Singapore, Singapore, SINGAPORE
FDA Status Not Applicable
Summary
High Tibial Osteotomy (HTO) and Unicompartmental Knee Arthroplasty (UKA) are both viable surgical options for young patients with osteoarthritis (OA). The decision between these procedures can be influenced by factors such as age, activity level, and anatomical considerations. With varus alignment more prevalent in Asian populations, outcomes of these procedures may vary.
ePosters will be available shortly before Congress
Abstract
Background
High Tibial Osteotomy (HTO) and Unicompartmental Knee Arthroplasty (UKA) are both viable surgical options for young patients with osteoarthritis (OA). The decision between these procedures can be influenced by factors such as age, activity level, and anatomical considerations. Notably, varus alignment is more prevalent in Asian populations, potentially affecting the choice and outcomes of these procedures. This meta-analysis aims to compare the outcomes of medial opening wedge HTO (MOWHTO) and UKA in Asian and Western populations, with a specific focus on the rate of revision to Total Knee Arthroplasty (TKA).
Methods
A comprehensive literature search was conducted across PubMed, Scopus, and Embase using search terms related to HTO and UKA. From 333 identified studies, 8 studies were included, and 2 additional studies were found manually. Included studies comprise 1 prospective study and 9 retrospective studies. The studies were evenly split between Asian and Western populations, all comparing Medial Opening Wedge High Tibial Osteotomies (MOWHTO) and UKA. Data on the rate of revision to TKA were extracted and analysed.
Results
In the Asian subgroup 562 knees were analysed and HTO demonstrated a lower, though not statistically significant, odds of revision to TKA compared to UKA (OR: 0.36, 95% CI: 0.12-1.07, p=0.07). In contrast, in the Western subgroup 235 knees were analysed and HTO was associated with a significantly higher risk of revision to TKA compared to UKA (OR: 4.70, 95% CI: 1.43-15.45, p=0.01). The heterogeneity was minimal in both subgroups (I² = 0%).
Conclusion
The results suggest significant differences in outcomes between Asian and Western populations undergoing HTO and UKA. The higher prevalence of varus alignment in Asian knees may favour HTO, while UKA may be more suitable for Western patients with different alignment profiles. The choice of procedure should consider these anatomical and biomechanical differences to optimize patient outcomes.