A prospective observational study to assess the functional and radiological outcomes of high tibial osteotomy in medial compartment osteoarthritis in younger population

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

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Clinical Results after Medial Opening Wedge High Tibial Osteotomy in Medial Compartment Osteoarthritis of the Knee: TomoFix® versus Aescula® Plates

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2015.50.5.379 ◽

2015 ◽

Vol 50 (5) ◽

pp. 379

Author(s):

Ju Hong Lee ◽

Hyuk Park ◽

Jong Hyun Ko

Keyword(s):

High Tibial Osteotomy ◽

Clinical Results ◽

Medial Compartment ◽

Osteoarthritis Of The Knee ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Medial Compartment Osteoarthritis ◽

Wedge High Tibial Osteotomy

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Functional Outcome of High Tibial Osteotomy in Patients with Medial Compartment Osteoarthritis Using Dynamic Axial Fixator -a prospective study

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2020.07.033 ◽

2020 ◽

Vol 11 ◽

pp. S902-S908

Author(s):

Amit kumar yadav ◽

Mangal parihar ◽

Eknath d Pawar ◽

Divya ahuja ◽

Sandeep gavhale ◽

...

Keyword(s):

Prospective Study ◽

Functional Outcome ◽

High Tibial Osteotomy ◽

Medial Compartment ◽

Tibial Osteotomy ◽

Medial Compartment Osteoarthritis ◽

A Prospective Study

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Assessing in vivo articular cartilage mechanosensitivity as outcome of high tibial osteotomy in patients with medial compartment osteoarthritis: Experimental protocol

Osteoarthritis and Cartilage Open ◽

10.1016/j.ocarto.2020.100043 ◽

2020 ◽

Vol 2 (2) ◽

pp. 100043

Author(s):

Annegret Mündermann ◽

Werner Vach ◽

Geert Pagenster ◽

Christian Egloff ◽

Corina Nüesch

Keyword(s):

Articular Cartilage ◽

High Tibial Osteotomy ◽

Medial Compartment ◽

Tibial Osteotomy ◽

Experimental Protocol ◽

Medial Compartment Osteoarthritis

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Cost-Effectiveness Analysis of Unicompartmental Knee Arthroplasty and High Tibial Osteotomy for Treatment of Medial Compartmental Osteoarthritis

The Duke Orthopaedic Journal ◽

10.5005/jp-journals-10017-1005 ◽

2011 ◽

Vol 1 (1) ◽

pp. 27-37 ◽

Cited By ~ 2

Author(s):

Christopher A Brown ◽

Tyler S Watters ◽

Richard C Mather ◽

Lori A Orlando

Keyword(s):

Cost Effectiveness ◽

High Tibial Osteotomy ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Decision Model ◽

Medial Compartment ◽

Tibial Osteotomy ◽

Medial Compartment Osteoarthritis ◽

Markov Decision ◽

Markov Decision Model

ABSTRACT Background Interest in unicompartmental knee arthroplasty (UKA) has recently increased in the United States concomitantly with an increase in the prevalence of physiologically active patients presenting with medial compartment osteoarthritis. This study examined the cost-effectiveness of UKA compared with high tibial osteotomy (HTO) in patients with medial compartment osteoarthritis. Methods A Markov decision model was constructed with review of literature to conduct a cost-utility analysis of UKA as compared to HTO in a patient population aged 40 years at the time of surgical intervention. Utility values were assigned to health states annually based on the commonly accepted reference values of 1 being “full health” and 0 being “death”. These values are used to estimate quality-adjusted life years (QALYs). The Markov decision model was used to evaluate the total accumulated costs and effectiveness, measured in QALYs. Results The average cost of the UKA was cheaper by $842 and resulted in a significant incremental effectiveness gain compared to HTO (+ 0.96 QALY). UKA gained 20.05 QALY at a cost-effectiveness (C/E) ratio of $1048/QALY, whereas HTO gained 19.09 QALY at a C/E ratio of $1145/QALY. Conclusion Both UKA and HTO are cost-effective procedures but patients treated with UKA may experience an increased net health benefit over their lifetime. Level of evidence Economic and decision analysis level II.

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