High Tibial Osteotomy versus Unicompartmental Knee Arthroplasty for Medial Compartment Arthrosis with Kissing Lesions in Relatively Young Patients
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this study is to compare the clinical and radiographic outcomes of high tibial osteotomy (HTO) and unicompartmental arthroplasty (UKA) in advanced medial compartment arthritis accompanied by kissing lesions in relatively young patients. Materials and Methods: Forty-five patients were divided into the HTO (n=23) and UKA (n=22) groups. Clinically, we evaluated the Lysholm knee scoring scale, visual analogue scale, Hospital for Special Surgery, and Western Ontario and McMaster Universities Osteoarthritis index scores preoperatively, 6 and 12 months postoperatively, and at the final follow-up. Radiographically, we measured the femoral-tibial angle and mechanical axis deviation preoperatively and at the final follow-up. Results: All clinical outcomes gradually improved in both groups from the postoperative period to the final follow-up. At the final follow-up, all clinical outcomes were slightly better in the UKA group than in the HTO group; however, differences were not statistically significant. Conclusions: HTO is comparable to UKA in terms of clinical outcomes. Thus, the results of this study suggest that HTO might be a good alternative treatment to UKA for medial unicompartmental arthritis accompanied by kissing lesions in relatively young patients.
Abstract
Purpose: The purpose of this study is to compare the clinical and radiographic outcomes of high tibial osteotomy (HTO) and unicompartmental arthroplasty (UKA) in advanced medial compartment arthritis accompanied by kissing lesions in relatively young patients. Materials and Methods: Forty-five patients were divided into the HTO (n=23) and UKA (n=22) groups. Clinically, we evaluated the Lysholm knee scoring scale, visual analogue scale, Hospital for Special Surgery, and Western Ontario and McMaster Universities Osteoarthritis index scores preoperatively, 6 and 12 months postoperatively, and at the final follow-up. Radiographically, we measured the femoral-tibial angle and mechanical axis deviation preoperatively and at the final follow-up. Results: All clinical outcomes gradually improved in both groups from the postoperative period to the final follow-up. At the final follow-up, all clinical outcomes were slightly better in the UKA group than in the HTO group; however, differences were not statistically significant. Conclusions: HTO is comparable to UKA in terms of clinical outcomes. Thus, the results of this study suggest that HTO might be a good alternative treatment to UKA for medial unicompartmental arthritis accompanied by kissing lesions in relatively young patients.
참고문헌 (30)
- Billings A, "High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion: long-term follow-up", J Bone Joint Surg Am, 82, pp.70~79 (2000)
- Murphy SB, "Tibial osteotomy for genu varum. Indications, preoperative planning, and technique", Orthop Clin North Am, 25, pp.477~482 (1994)
- Weale AE, "High tibial osteotomy using a dynamic axial external fixator", Clin Orthop Relat Res, (382), pp.154~167 (2001)
- Naudie D, "The Install Award: survivorship of the high tibial valgus osteotomy: a 10- to -22-year followup study", Clin Orthop Relat Res, (367), pp.18~27 (1999)
- Preston S, "Total knee arthroplasty after high tibial osteotomy: no differences between medial and lateral osteotomy approaches", Clin Orthop Relat Res, 472, pp.105~110 (2014)[DOI]
- Naudie DD, "Opening wedge high tibial osteotomy for symptomatic hyperextension-varus thrust", Am J Sports Med, 32, pp.60~70 (2004)[DOI]
- Kozinn SC, "Unicondylar knee arthroplasty", J Bone Joint Surg Am, 71, pp.145~150 (1989)[DOI]
- Borus T, "Unicompartmental knee arthroplasty", J Am Acad Orthop Surg, 16, pp.9~18 (2008)[DOI]
- Dettoni F, "High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature", Iowa Orthop J, 30, pp.131~140 (2010)
- Rossi R, "The role of high tibial osteotomy in the varus knee", J Am Acad Orthop Surg, 19, pp.590~599 (2011)[DOI]
- Bonasia DE, "Medial opening wedge high tibial osteotomy for medial compartment overload", arthritis in the varus knee: prognostic factors, 2014, pp.42, 690~698
- Hang JR, "Outcome of revision of unicompartmental knee replacement", Acta Orthop, 81, pp.95~98 (2010)[DOI]
- Pascale W, "Do microfractures improve high tibial osteotomy outcome?", Orthopedics, 34, pp.251~255 (2011)
- van den Bekerom MP, "Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years", J Knee Surg, 20, pp.271~276 (2007)
- 손욱진, "Comparative Study of Clinical and Radiographic Outcomes of High Tibial Osteotomy in Patients with Kissing Lesions and Non-Kissing Lesions", Knee Surgery and Related Research, 29(4), pp.288~294 (2017), 대한슬관절학회
- Fujisawa Y, "The effect of high tibial osteotomy on osteoarthritis of the knee: an arthroscopic study of 54 knee joints", Orthop Clin North Am, 10, pp.585~608 (1979)
- Lysholm J, "Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale", Am J Sports Med, 10, pp.150~154 (1982)[DOI]
- Carlsson AM, "Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale", Pain, 16, pp.87~101 (1983)[DOI]
- Insall JN, "Rationale of the Knee Society clinical rating system", Clin Orthop Relat Res, (248), pp.13~14 (1989)
- Bellamy N, "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, pp.1833~1840 (1988)
- Erdfelder E, "GPOWER: a general power analysis program", Behav Res Methods Instrum Comput, 28, pp.1~11 (1996)[DOI]
- Ivarsson I, "Rehabilitation after high tibial osteotomy and unicompartmental arthroplasty: a comparative study", Clin Orthop Relat Res, (266), pp.139~144 (1991)
- Nwachukwu BU, "Unicompartmental knee arthroplasty versus high tibial osteotomy: United States practice patterns for the surgical treatment of unicompartmental arthritis", J Arthroplasty, 29, pp.1586~1589 (2014)[DOI]
- Yim JH, "Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years", J Arthroplasty, 28, pp.243~247 (2013)[DOI]
- Borjesson M, "Gait and clinical measurements in patients with knee osteoarthritis after surgery: a prospective 5-year follow-up study", Knee, 12, pp.121~127 (2005)[DOI]
- Takeuchi R, "A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee", J Orthop Surg Res, 5, pp.65~ (2010)[DOI]
- Stukenborg-Colsman C, "High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study", Knee, 8, pp.187~194 (2001)[DOI]
- W-Dahl A, "Surgery for knee osteoarthritis in younger patients", Acta Orthop, 81, pp.161~164 (2010)[DOI]
- Warme BA, "Is there a role for high tibial osteotomies in the athlete?", Sports Health, 3, pp.59~69 (2011)[DOI]
- Mancuso F, "Medial unicompartmental knee arthroplasty in the ACL-deficient knee", J Orthop Traumatol, 17, pp.267~275 (2016)[DOI]