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- Title
Long-term survival is similar between closed-wedge high tibial osteotomy and unicompartmental knee arthroplasty in patients with similar demographics.
- Authors
Song, Sang Jun; Bae, Dae Kyung; Kim, Kang Il; Park, Cheol Hee
- Abstract
<bold>Purpose: </bold>Long-term clinical and radiographic results and survival rates were compared between closed-wedge high tibial osteotomy (HTOs) and fixed-bearing unicompartmental knee arthroplasty (UKA) in patients with similar demographics.<bold>Methods: </bold>Sixty HTOs and 50 UKAs completed between 1992 and 1998 were retrospectively reviewed. There were no significant differences in pre-operative demographics. The mean follow-up period was 10.7 ± 5.7 years for HTO and 12.0 ± 7.1 years for UKA (n.s.). The Knee Society knee and function scores, WOMAC, and range of motion (ROM) were investigated. The mechanical axis and femorotibial angle were evaluated. Kaplan-Meier survival analysis was performed (failure: revision to TKA) and the failure modes were investigated.<bold>Results: </bold>Most of the clinical and radiographic results were not different at the last follow-up, except ROM; ROM was 135.3° ± 12.3° in HTO and 126.8° ± 13.3° in UKA (p = 0.005). The 5-, 10-, 15-, and 20-year survival rates were 100%, 91.0%, 63.4%, and 48.3% for closed-wedge HTO, respectively, and 90.5%, 87.1%, 70.8%, and 66.4% for UKA (n.s.). The survival rate was higher than that for UKA until 12 years post-operatively but was higher in UKAs thereafter, following a remarkable decrease in HTO. The most common failure mode was degenerative osteoarthritic progression of medial compartment in HTO and femoral component loosening in UKA.<bold>Conclusions: </bold>Long-term survival did not differ significantly between closed-wedge HTO and fixed-bearing UKA in patients with similar pre-operative demographics and knee conditions. The difference in post-operative ROM and failure mode should be considered when selecting a procedure.<bold>Level Of Evidence: </bold>III.
- Subjects
OSTEOTOMY; TIBIAL plateau fractures; TOTAL knee replacement; ARTHROPLASTY; ARTIFICIAL knees; KNEE surgery; OSTEOARTHRITIS diagnosis; TIBIA surgery; RANGE of motion of joints; KNEE; KNEE diseases; LONGITUDINAL method; OSTEOARTHRITIS; REOPERATION; TIBIA; TIME; TREATMENT effectiveness; RETROSPECTIVE studies; DISEASE progression
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 4, p1310
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05390-w