Skip to main content
Top
Published in: International Orthopaedics 11/2019

01-11-2019 | Original Paper

Unicompartmental knee arthroplasty is superior to high tibial osteotomy in post-operative recovery and participation in recreational and sports activities

Authors: Man Soo Kim, In Jun Koh, Sueen Sohn, Ji Hwan Jeong, Yong In

Published in: International Orthopaedics | Issue 11/2019

Login to get access

Abstract

Purpose

To compare (1) the recovery pattern of post-operative physical activity and function in the early post-operative period and (2) the difference of participation in recreational and sports activities pre- and post-operatively following unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).

Methods

In this prospective comparative study, 49 HTOs (49 patients) and 42 UKAs (42 patients) performed to treat medial compartmental knee osteoarthritis (OA) were included. The pain visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), Tegner activity score, Lysholm knee score, and the University of California at Los Angeles (UCLA) activity score were evaluated pre-operatively and post-operatively at three, six, 12, and 24 months. Participation in recreational and sports activities was also assessed pre-operatively and 24 months post-operatively.

Results

Pre-operatively, although there were no differences in VAS, WOMAC, and Lysholm scores between the two groups, the UKA group had inferior Tegner and UCLA scores (p < 0.05). At post-operative three and six months, the UKA group showed superior VAS, WOMAC, and Lysholm scores (p < 0.05 for all). However, at 12 and 24 months post-operatively, both groups had similar outcome scores (p > 0.05 for all). When all the baseline scores were adjusted for the mean changes, the UKA group showed a significantly better UCLA score than the HTO group until 12 months after the operation (p = 0.008). The rate of return to sports activity was 94.1% in the UKA group and 75.0% in the HTO group at 24 months post-operatively (p = 0.031).

Conclusion

These findings indicate that UKA had better short-term functional outcomes and return to recreational and sports activities than did HTO in patients with medial OA.
Literature
3.
go back to reference Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R (2010) High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J 30:131–140PubMedPubMedCentral Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R (2010) High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J 30:131–140PubMedPubMedCentral
10.
go back to reference Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplast 13:890–895CrossRef Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplast 13:890–895CrossRef
11.
go back to reference Mancuso CA, Sculco TP, Wickiewicz TL, Jones EC, Robbins L, Warren RF, Williams-Russo P (2001) Patients’ expectations of knee surgery. J Bone Joint Surg Am 83-a:1005–1012CrossRef Mancuso CA, Sculco TP, Wickiewicz TL, Jones EC, Robbins L, Warren RF, Williams-Russo P (2001) Patients’ expectations of knee surgery. J Bone Joint Surg Am 83-a:1005–1012CrossRef
14.
go back to reference Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A (2001) High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee 8:187–194CrossRef Stukenborg-Colsman C, Wirth CJ, Lazovic D, Wefer A (2001) High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee 8:187–194CrossRef
17.
go back to reference Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502CrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502CrossRef
18.
go back to reference Cooke TD, Li J, Scudamore RA (1994) Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am 25:387–393PubMed Cooke TD, Li J, Scudamore RA (1994) Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am 25:387–393PubMed
19.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
20.
go back to reference Odenbring S, Tjornstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhoj T, Svanstrom A (1989) Function after tibial osteotomy for medial gonarthrosis below aged 50 years. Acta Orthop Scand 60:527–531CrossRef Odenbring S, Tjornstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhoj T, Svanstrom A (1989) Function after tibial osteotomy for medial gonarthrosis below aged 50 years. Acta Orthop Scand 60:527–531CrossRef
21.
go back to reference Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res:43–49 Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res:43–49
26.
go back to reference Cho WJ, Kim JM, Kim WK, Kim DE, Kim NK, Bin SI (2018) 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. https://doi.org/10.1007/s00264-018-3880-4 CrossRef Cho WJ, Kim JM, Kim WK, Kim DE, Kim NK, Bin SI (2018) 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. https://​doi.​org/​10.​1007/​s00264-018-3880-4 CrossRef
27.
go back to reference Ivarsson I, Gillquist J (1991) Rehabilitation after high tibial osteotomy and unicompartmental arthroplasty. A comparative study. Clin Orthop Relat Res:139–144 Ivarsson I, Gillquist J (1991) Rehabilitation after high tibial osteotomy and unicompartmental arthroplasty. A comparative study. Clin Orthop Relat Res:139–144
32.
go back to reference Saxon L, Finch C, Bass S (1999) Sports participation, sports injuries and osteoarthritis: implications for prevention. Sports Med 28:123–135CrossRef Saxon L, Finch C, Bass S (1999) Sports participation, sports injuries and osteoarthritis: implications for prevention. Sports Med 28:123–135CrossRef
Metadata
Title
Unicompartmental knee arthroplasty is superior to high tibial osteotomy in post-operative recovery and participation in recreational and sports activities
Authors
Man Soo Kim
In Jun Koh
Sueen Sohn
Ji Hwan Jeong
Yong In
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4272-5

Other articles of this Issue 11/2019

International Orthopaedics 11/2019 Go to the issue