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Closed-wedge HTO and
fixed-bearing UKA have similar long term survival in OA patients, but the
differences in post-operative ROM and failure mode should be considered while
selecting a procedure.
No long-term survival rates were seen with closed-wedge HTO and fixed-bearing UKA, optimal surgical treatments for medial compartmental osteoarthritis (OA), as per the findings of a recently published study in the Journal of Knee Surgery, Sports Traumatology, Arthroscopy.
Generally, UKA is famous for older patients with low activity and HTO for young and active patients. However, which out of two is best for patients with OA severity of grade 3 or 4 with an age of 55 and 65 years is hard to decide, and while opting these surgical treatments, longevity becomes an important factor. This analysis tried to find these missing links.
Fifty and sixty patients with similar pre-operative demographics who went through
UKAs and HTOs from 1992 to 1998, respectively were selected and evaluated for
WOMAC, the range of motion (ROM), Knee Society knee and function scores,
femorotibial angle and mechanical axis. The mean follow-up period noticed for
UKAs and HTOs was 12.0±7.1 and 10.7±5.7 years, respectively. Failure modes were
also reviewed.
Except for ROM, patients of both groups exhibited similar radiographical and
clinical outcomes. Until 12 years after the treatment, the survival rate was
higher in HTO, but decrease after that and became higher in UKAs. Loosening of
the femoral component and the progression of degenerative osteoarthritis were
the most common failure modes noticed in UKA and HTO groups, respectively. As per the findings, patients with similar
knee conditions and pre-operative demographics showed no difference in the
survival rates of HTO and UKA, and these rates of survival were not found to be
of long-term.
Knee Surg Sports Traumatol Arthrosc
Long-term survival is similar between closed-wedge high tibial osteotomy and unicompartmental knee arthroplasty in patients with similar demographics.
Sang Jun Song et al.
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