A meta-analysis of high tibial osteotomy and monocondylar replacement for treating medial interventricular osteoarthritis of the knee

doi:10.3969/j.issn.2095-4344.2844

Abstract

Abstract:

BACKGROUND: The most common surgical methods for the treatment of medial interventricular osteoarthritis of the knee are high tibial osteotomy and monocondylar replacement, and systematic evaluation of the difference in efficacy between the two is still lacking.

OBJECTIVE: To compare the clinical efficacy of high tibial osteotomy and monocondylar replacement in the treatment of medial interventricular osteoarthritis of the knee.

METHODS: PubMed, The Cochrane library, EMBASE, ScienceDirect, CNKI, Wanfang, and VIP were searched by computer. Literature was collected on observational cohort studies or randomized controlled trials comparing high tibial osteotomy/monocondylar replacement in the treatment of medial interventricular osteoarthritis of the knee, with a retrieval period from 2000 to 2019. Two people independently read and screened literature, extracted data and evaluated the quality of the study. RevMan 5.3 software was used for data analysis.

RESULTS AND CONCLUSION: (1) A total of 13 studies were included, with 711 patients. (2) Meta-analysis results showed that the knee range of motion of high tibial osteotomy group (MD=-5.47, 95%CI: -9.53 to -1.41, P=0.008) was significantly better than that of monocondylar replacement group. Lysholm knee score (MD=0.84, 95%CI: 0.29 to 1.39, P=0.003) in the monocondylar replacement group at the last follow-up was significantly better than that of the high tibial osteotomy group. (3) There were no significant differences between the two groups in the incidence of postoperative complications, revision rate of total knee replacement, postoperative infection rate, degeneration rate of patellofemoral articular cartilage, degeneration rate of lateral compartment, excellent and good rate, and tibiofemoral angle after surgery (P > 0.05). (4) It is concluded that in the treatment of medial interventricular osteoarthritis of the knee according to the indications of operation, high tibial osteotomy can obtain similar complications, postoperative revision rate of total knee arthroplasty, postoperative infection, degeneration rate of patellofemoral articular cartilage, degeneration rate of the lateral compartment, excellent and good rate, postoperative tibial angle as monocondylar replacement, but the postoperative motion range of high tibial osteotomy is better than that of monocondylar replacement, while monocondylar replacement enables better knee function.

Key words: high tibial osteotomy, monocondylar replacement, knee, medial compartment, osteoarthritis, meta-analysis

CLC Number:

Bai Hao, Sun Haibiao, Han Xiaoqiang, Xue Jiangang. A meta-analysis of high tibial osteotomy and monocondylar replacement for treating medial interventricular osteoarthritis of the knee[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(30): 4905-4913.

Figures/Tables 15

References

[1] LOESER RF. Aging and osteoarthritis: the role of chondrocyte senescence and aging changes in the cartilage matrix. Osteoarthritis Cartilage. 2009;17(8):971-979.

[2] RYU SM, PARK JW, NA HD, et al. High Tibial Osteotomy versus Unicompartmental Knee Arthroplasty for Medial Compartment Arthrosis with Kissing Lesions in Relatively Young Patients. Knee Surg Relat Res. 2018;30(1):17-22.

[3] HAN SB, KYUNG HS, SEO IW, et al. Better clinical outcomes after unicompartmental knee arthroplasty when comparing with high tibial osteotomy. Medicine (Baltimore). 2017;96(50):e9268.

[4] DETTONI F, BONASIA DE, CASTOLDI F, et al. High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J. 2010;30:131-140.

[5] KIM YJ, KIM BH, YOO SH, et al. Mid-term results of oxford medial unicompartmental knee arthroplasty in young asian patients less than 60 years of age: a minimum 5-year follow-up. Knee Surg Relat Res. 2017;29(2):122-128.

[6] TAKEUCHI R, UMEMOTO Y, ARATAKE M, et al. A midterm comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee. J Orthop Surg Res. 2010;5(1):65.

[7] CHO WJ, KIM JM, KIM WK, et al. Mobile-bearing unicompartmental knee arthroplasty in old-aged patients demonstrates superior short-term clinical outcomes to open-wedge high tibial osteotomy in middle-aged patients with advanced isolated medial osteoarthritis. Int Orthop. 2018;42(10): 2357-2363.

[8] PETERSEN W, METZLAFF S. Open wedge high tibial osteotomy (HTO) versus mobile bearing unicondylar medial joint replacement: five years results. Arch Orthop Trauma Surg. 2016; 136(7):983-989.

[9] SONG SJ, BAE DK, KIM KI, et al. 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. 2019; 27(4):1310-1319.

[10] STUKENBORG-COLSMAN C, WIRTH CJ, LAZOVIC D, et al. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee. 2001;8(3):187-194.

[11] YIM JH, SONG EK, SEO HY, et al. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplasty. 2013;28(2):243-247.

[12] BODE G, VON HEYDEN J, PESTKA J, et al. Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2015;23(7): 1949-1955.

[13] BONASIA DE, DETTONI F, SITO G, et al. Medial opening wedge high tibial osteotomy for medial compartment overload/arthritis in the varus knee: prognostic factors. Am J Sports Med. 2014;42(3): 690-698.

[14] FU D, LI G, CHEN K, et al. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty. 2013;28(5):759-765.

[15] HERRY Y, BATAILLER C, LORDING T, et al. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic- assisted surgical technique. Int Orthop. 2017;41(11): 2265-2271.

[16] SARAGAGLIA D, BEVAND A, REFAIE R, et al. Results with nine years mean follow up on one hundred and three KAPS(R) uni knee arthroplasties: eighty six medial and seventeen lateral. Int Orthop. 2018;42(5):1061-1066.

[17] RICHMOND JC. Surgery for osteoarthritis of the knee. Rheum Dis Clin North Am. 2013;39(1):203-211.

[18] SANTOSO MB, WU L. Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review. J Orthop Surg Res. 2017;12(1):50.

[19] 杨波,姜鑫.单髁置换术与胫骨高位截骨术治疗膝关节内侧间室骨关节炎的近期疗效比较[J].中国修复重建外科杂志,2015,29(5): 548-552.

[20] 唐华林,李玉军.单髁置换术与胫骨高位截骨术治疗膝骨性关节炎的效果对比分析[J].临床医药文献电子杂志,2017,4(77):15096-15097.

[21] 丁勇,李钊,胡运生,等.单髁置换术与胫骨高位截骨术治疗膝骨性关节炎疗效比较[J].生物骨科材料与临床研究,2015,12(2):75-77.

[22] 陈锐鸿,葛鸿庆,陈文治.单髁置换与胫骨高位截骨治疗膝关节内侧间室骨关节炎:1年随访比较[J].中国组织工程研究,2019,23(20): 3143-3147.

[23] 张凯,王晓鹏,戴志刚.胫骨高位截骨术与单髁置换术治疗膝内侧间室关节炎临床疗效对比[J].潍坊医学院学报, 2019,41(3):207-209.

[24] 李宇,王立志,郑秋,等.胫骨高位截骨与膝单髁置换治疗内侧间室骨关节炎的近期疗效比较[J].中国现代医学杂志, 2019,29(16):75-79.

[25] AMIN AK, PATTON JT, COOK RE, et al. Unicompartmental or total knee arthroplasty?: Results from a matched study. Clin Orthop Relat Res. 2006;451:101-106.

[26] KYUNG HS. High tibial osteotomy for medial knee osteoarthritis. Knee Surg Relat Res. 2016;28:253-254.

[27] PARKER DA, VISKONTAS DG. Osteotomy for the early varus arthritic knee. Sports Med Arthrosc. 2007;15:3-14.

[28] ENGH GA. Orthopaedic crossfire-can we justify unicondylar arthroplasty as a temporizing procedure? In the affirmative. J Arthroplasty. 2002;17:54-55.

[29] KO YB, GUJARATHI MR, OH KJ. Outcome of unicompartmental knee arthroplasty: a systematic review of comparative studies between fixed and mobile bearings focusing on complications. Knee Surg Relat Res. 2015;27:141-148.

[30] 宋伟,朱振国,徐进,等.单髁置换术与胫骨高位截骨术治疗膝关节骨性关节炎的荟萃分析[J].中国矫形外科杂志,2018,26(21): 1962-1968

[31] IVARSSON I, GILLQUIST J. Rehabilitation after high tibial osteotomy and unicompartmental arthroplasty. Clin Orthop Relat Res. 1991;266:139-144.

[32] ANDRIACCHI TP, GALANTE JO, FERMIER RW. The influence of total knee-replacement design on walking and stair-climbing. J Bone Joint Surg Am. 1982;64:1328-1335.

[33] WEINSTEIN JN, ANDRIACCHI TP, GALANTE J. Factors influencing walking and stair climbing following unicompartmental knee arthroplasty. J Arthroplasty. 986;1:109-115.

[34] CARTIER P, SANOUILLER JL, GRELSAMER RP. Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty. 1996;11:782-788.