The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis
- 11 November 2011
- journal article
- research article
- Published by Wiley in Knee Surgery, Sports Traumatology, Arthroscopy
- Vol. 21 (1), 96-112
- https://doi.org/10.1007/s00167-011-1751-2
Abstract
Both high tibial valgus osteotomy (HTO) and unicompartmental medial knee arthroplasty (UKA) are established methods for the treatment for moderate stages of OA. This is the first global meta-analysis to compare the long-term effects of both methods regarding survival, outcomes and complications of total arthroplasty. Literature research was performed using established medical databases: MEDLINE (via PubMed), EMBASE (via OVID) and the Cochrane register. Criteria for inclusion were as follows: English or German papers, a clinical trial with a clear description of survival, an outcome evaluation using a well-described knee score and a follow-up >5 years. Statistical analysis was performed using the special meta-analysis software called “Comprehensive Meta Analysis” (version 2.0; Biostat, Englewood, NJ, USA). Final meta-analysis after the full-text review included 46 studies about valgus HTO and 43 studies about medial UKA. There were no significant differences between valgus HTO and medial UKA in terms of the number of total required replacements. After a 5- to 8-year follow-up, 91.0% of the valgus HTO patients and 91.5% of medial UKA patients did not need a total replacement. This value was 84.4% for valgus HTOs and 86.9% for medial UKAs after a 9- to 12-year follow-up. Mean survival time to TKA was 9.7 years after valgus HTO and 9.2 years after medial UKA. Clinical outcome was significantly better after medial UKA in a 5- to 12-year follow-up. After more than 12 years, results were comparable in both groups. No significant differences were seen in the complication rates. This meta-analysis aimed to find the advantages and disadvantages of two established methods for the treatment for medial compartment knee osteoarthritis. Valgus HTO is more appropriate for younger patients who accept a slight decrease in their physical activity. Medial UKA is appropriate for older patients obtaining sufficient pain relief but with reduced physical activity. II.Keywords
This publication has 123 references indexed in Scilit:
- The Swedish Knee Arthroplasty Register (www.knee.se)Acta Orthopaedica, 2010
- High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-upInternational Orthopaedics, 2010
- Long-term clinical results of the Oxford medial unicompartmental knee arthroplastyInternational Orthopaedics, 2009
- Medial unicompartmental knee replacement in the under-50sThe Journal of Bone and Joint Surgery. British volume, 2009
- High tibial osteotomy using two threaded pins and figure-of-eight wiring fixation for medial knee osteoarthritis: 14 to 24 years follow-up resultsJournal of Orthopaedic Science, 2008
- Deterioration of long-term results following high tibial osteotomy in patients under 60 years of ageInternational Orthopaedics, 2006
- Registration completeness in the Norwegian Arthroplasty RegisterActa Orthopaedica, 2006
- Measuring inconsistency in meta-analysesBMJ, 2003
- High tibial osteotomy for varus gonarthrosis: a 10- to 24-year follow-up studyJournal of Orthopaedic Science, 2001
- Radiological Assessment of Osteo-ArthrosisAnnals Of The Rheumatic Diseases, 1957