Long-term survival is similar between closed-wedge high tibial osteotomy and unicompartmental knee arthroplasty in patients with similar demographics.
Knee Surg Sports Traumatol Arthrosc
; 27(4): 1310-1319, 2019 Apr.
Article
en En
| MEDLINE
| ID: mdl-30719541
ABSTRACT
PURPOSE:
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.METHODS:
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.RESULTS:
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.CONCLUSIONS:
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. LEVEL OF EVIDENCE III.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Osteotomía
/
Tibia
/
Rango del Movimiento Articular
/
Artroplastia de Reemplazo de Rodilla
/
Osteoartritis de la Rodilla
/
Articulación de la Rodilla
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Asunto de la revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Corea del Sur