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Archives of Orthopaedic and Trauma Surgery

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27-04-2023 | Osteoarthrosis | Knee Arthroplasty

Patient-reported outcome measures after mobile-bearing unicompartmental knee arthroplasty were better than medial opening-wedge high tibial osteotomy in early elderly patients with severe osteoarthritis

Authors: Shinichiro Okimura, Tomoyuki Suzuki, Takashi Matsumura, Yasutoshi Ikeda, Kousuke Shiwaku, Atsushi Teramoto, Toshihiko Yamashita

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2023

Abstract

Background

Many countries are faced with aging populations. However, few studies have directly compared the clinical outcomes of medial opening-wedge high tibial osteotomy (OWHTO) and mobile-bearing unicompartmental knee arthroplasty (MB-UKA) in early elderly patients. Thus, we aimed to investigate the clinical outcomes after OWHTO and MB-UKA in early elderly patients with similar demographics and osteoarthritis (OA) severity.

Methods

Three hundred and fifteen OWHTO and 142 MB-UKA were performed for medial compartment OA by a single surgeon between August 2009 and April 2020. Among them, patients aged 65–74 years with more than two years of follow-up were enrolled. The patient-reported outcome measures (PROMs), including visual analog scale (VAS) score and Japanese Knee Osteoarthritis Measure (JKOM) score, were compared between both procedures preoperatively and at the last follow-up. The PROMs were compared between the groups by Kellgren–Lawrence (K–L) OA grades.

Results

Seventy-three OWHTO and 37 MB-UKA patients were enrolled. No significant differences were found in the distribution of age, gender, follow-up period, body mass index, and Tegner activity scale between the two procedures. The postoperative PROMs in patients with K–L grade 4 were better after MB-UKA than OWHTO at the mean follow-up of 5 years. No significant difference was found in PROMs in patients with K–L grades 2 and 3.

Conclusion

ThePROMs after MB-UKA were superior to that after OWHTO in early elderly patients with severe OA. In particular, pain relief was better after MB-UKA than OWHTO with severe OA. Meanwhile, no significant difference in PROMs was found with moderate OA patients.

Level of evidence

Level IVprospective cohort study.

Fu D, Li G, Chen K et al (2013) Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty 28:759–765. https://doi.org/10.1016/j.arth.2013.02.010CrossRefPubMed

Spahn G, Hofmann GO, von Engelhardt LV et al (2013) The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 21:96–112. https://doi.org/10.1007/s00167-011-1751-2CrossRefPubMed

Kim MS, Koh IJ, Sohn S et al (2019) Unicompartmental knee arthroplasty is superior to high tibial osteotomy in post-operative recovery and participation in recreational and sports activities. Int Orthop 43:2493–2501. https://doi.org/10.1007/s00264-018-4272-5CrossRefPubMed

Petersen W, Metzlaff S (2016) Open wedge high tibial osteotomy (HTO) versus mobile bearing unicondylar medial joint replacement: five years results. Arch Orthop Trauma Surg 136:983–989. https://doi.org/10.1007/s00402-016-2465-1CrossRefPubMed

Koh IJ, Kim MS, Sohn S et al (2019) Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis. Orthop Traumatol Surg Res 105:77–83. https://doi.org/10.1016/j.otsr.2018.11.001CrossRefPubMed

Jin QH, Lee WG, Song EK et al (2021) Comparison of long-term survival analysis between open-wedge high tibial osteotomy and unicompartmental knee arthroplasty. J Arthroplasty. https://doi.org/10.1016/j.arth.2020.11.008CrossRefPubMed

Goshima K, Sawaguchi T, Sakagoshi D et al (2017) Age does not affect the clinical and radiological outcomes after open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25:918–923. https://doi.org/10.1007/s00167-015-3847-6CrossRefPubMed

Takeuchi R, Ishikawa H, Aratake M et al (2009) Medial opening wedge high tibial osteotomy with early full weight bearing. Arthroscopy 25:46–53. https://doi.org/10.1016/j.arthro.2008.08.015CrossRefPubMed

Floerkemeier S, Staubli AE, Schroeter S et al (2013) Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc 21:170–180. https://doi.org/10.1007/s00167-012-2087-2CrossRefPubMed

10.

Orimo H, Ito H, Suzuki T et al (2006) Reviewing the definition of “early eldery.” Geriatr Gerontol Int 6:149–158CrossRef

11.

Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49CrossRef

12.

Akai M, Doi T, Fujino K et al (2005) An outcome measure for Japanese people with knee osteoarthritis. J Rheumatol 32:1524–1532PubMed

13.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed

14.

Bellamy N, Buchanan WW, Goldsmith CH et al (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

15.

Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502. https://doi.org/10.1136/ard.16.4.494CrossRefPubMedPubMedCentral

16.

Trieb K, Grohs J, Hanslik-Schnabel B et al (2006) Age predicts outcome of high-tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 14:149–152. https://doi.org/10.1007/s00167-005-0638-5CrossRefPubMed

17.

Torres L, Dunlop DD, Peterfy C et al (2006) The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis. Osteoarthritis Cartilage 14:1033–1040. https://doi.org/10.1016/j.joca.2006.03.015CrossRefPubMed

Title: Patient-reported outcome measures after mobile-bearing unicompartmental knee arthroplasty were better than medial opening-wedge high tibial osteotomy in early elderly patients with severe osteoarthritis
Authors: Shinichiro Okimura
Tomoyuki Suzuki
Takashi Matsumura
Yasutoshi Ikeda
Kousuke Shiwaku
Atsushi Teramoto
Toshihiko Yamashita
Publication date: 27-04-2023
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04888-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Patient-reported outcome measures after mobile-bearing unicompartmental knee arthroplasty were better than medial opening-wedge high tibial osteotomy in early elderly patients with severe osteoarthritis

Abstract

Background

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of evidence

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