Published online May 18, 2024. doi: 10.5312/wjo.v15.i5.444
Revised: March 5, 2024
Accepted: April 12, 2024
Published online: May 18, 2024
Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are well-established operative interventions in the treatment of knee osteoarthritis. However, which intervention is more beneficial to patients with knee osteo
To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis: Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.
This longitudinal observational study assessed a total of 42 patients that had undergone UKA (n = 23) and HTO (n = 19) to treat medial compartment knee osteoarthritis. Patient-reported outcome measures (PROMs) were collected to evaluate clinical outcome. These included two disease-specific (Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score) and two generic (EQ-5D-5L, Short Form-12) PROMs. The radiographic parameters of knee alignment assessed were the: Hip-knee-ankle angle, mechanical axis deviation and angle of Mikulicz line.
Statistical analyses demonstrated significant (P < 0.001), preoperative to postoperative, improvements in the PROM scores of both groups. There were, however, no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group. Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively (P < 0.05). Postoperatively, two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment para
UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis. Clinical outcome has a limited association with radiographic para
Core Tip: A great deal of uncertainty exists in the literature about which operation, out of unicompartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO), is more beneficial in the treatment of knee osteoarthritis. This study adds evidence to the existing literature base, concluding that HTOs and UKAs are equally efficacious operative interventions capable of providing a comparable degree of improvement in joint function and global health-related quality of life, to those with medial compartment knee osteoarthritis at one year postoperatively. This study is the first of its kind to report a correlation analysis between the angle of Mikulicz line and patient-reported health outcomes. It demonstrated that preoperatively, a more distolaterally angled Mikulicz line was associated worse knee function/health-related quality of life. The mechanisms underlying this relationship remain unknown and represent an avenue for future research; the authors of this study posit an association with the external knee adduction moment.