Evaluation of arthroscopy combined with high tibial osteotomy and unicompartmental knee arthroplasty for single compartmental knee osteoarthritis

doi:10.3877/cma.j.issn.2096-0263.2024.04.006

Abstract

Abstract:

Objective

The purpose of this study was to compare the arthroscopy combined with high tibial osteotomy and unicompartmental knee arthroplasty for single compartmental knee osteoarthritis.

Methods

Fifty-four patients with knee osteoarthritis treated with high tibial osteotomy and unicompartmental knee arthroplasty were reviewed in our hospital between June 2020 and December 2021. Demographics, surgical data, postoperative complications, and functional outcomes were assessed, and followed up and clinical evaluation at 1, 3, 6, and 12 months before and after surgery.

Results

29 patients in the osteotomy group were followed up for a period of (1.2±0.3) years. There were 10 males and 19 females with an average age of (59.4±4.2) years. 25 patients in the UKA group were followed up for a period of (1.1±0.3) years. There were 9 males and 16 females with an average age of (58.9±5.1) years. The average femorotibial angle in the osteotomy group was significantly better than that in UKA group (175.45±1.27 vs 168.64±0.76°, P<0.01). Demographics, surgical data, and other prognostic parameters were comparative between the two groups.

Conclusions

Both arthroscopies combined with high tibial osteotomy and unicompartmental knee arthroplasty were effective methods for single compartmental knee osteoarthritis, and patients with arthroscopy combined with high tibial osteotomy observed better limb alignment than that in patients with unicompartmental knee arthroplasty.

Key words: Knee osteoarthritis, Unicompartmental knee arthroplasty, High tibial osteotomy

Haoting Wang, Yuntao Shang, Guang Cao, Yanci Zhang, Junyong Li. Evaluation of arthroscopy combined with high tibial osteotomy and unicompartmental knee arthroplasty for single compartmental knee osteoarthritis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(04): 229-236.

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Figures/Tables 7

References 23

1	Nelson AE. Osteoarthritis year in review 2017: clinical [J]. Osteoarthritis Cartilage, 2018, 26(3): 319-325.
2	黄野,柳剑,王兴山,等.胫骨高位截骨术适应证解析[J].中华外科杂志, 2020, 58(6): 420-424.
3	Hoorntje A, Witjes S, Kuijer PPFM, et al. High rates of return to sports activities and work after osteotomies around the knee: a systematic review and Meta-Analysis [J]. Sports Med, 2017, 47(11): 2219-2244.
4	Witjes S, Gouttebarge V, Kuijer PPFM, et al. Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and Meta-Analysis [J]. Sports Med, 2016, 46(2): 269-292.
5	李立,徐卫东.膝关节单髁置换术的并发症及防治[J].中华关节外科杂志:电子版, 2018, 12(3): 80-83.
6	Wilson HA, Middleton R, Abram SGF, et al. Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis [J]. BMJ, 2019, 364: l352.
7	Tang X, Wang SF, Zhan SY, et al. The prevalence of symptomatic knee osteoarthritis in China: results from the China health and retirement longitudinal study [J]. Arthritis Rheumatol, 2016, 68(3): 648-653.
8	李振科,匡光志,冯华杰,等.单髁与全膝置换治疗膝关节单间室骨关节炎的近中期疗效[J].中华关节外科杂志:电子版, 2019, 13(4): 503-508.
9	Song MH, Kim BH, Ahn SJ, et al. Early complications after minimally invasive mobile-bearing medial unicompartmental knee arthroplasty [J]. J Arthroplasty, 2009, 24(8): 1281-1284.
10	Morris MJ, Molli RG, Berend KR, et al. Mortality and perioperative complications after unicompartmental knee arthroplasty [J]. Knee, 2013, 20(3): 218-220.
11	Kagan R, Anderson MB, Bailey T, et al. Ten-Year survivorship, Patient-Reported outcomes, and satisfaction of a Fixed-Bearing unicompartmental knee arthroplasty [J]. Arthroplast Today, 2020, 6(2): 267-273.
12	Cheng JB, Feng ML, Cao GL, et al. Patient outcomes in Anteromedial osteoarthritis patients over 80 years old undergoing Oxford Unicompartmental knee Arthroplasty in China [J]. BMC Musculoskelet Disord, 2020, 21(1): 446.
13	郭东辉,李晓明,马世强,等.关节镜下清理联合胫骨近端高位截骨TomoFix内固定术治疗内翻性膝骨关节炎[J].实用骨科杂志, 2020, 26(4): 368-371.
14	Sun H, Zhou L, Li FS, et al. Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis [J]. J Knee Surg, 2017, 30(2): 158-165.
15	徐海军,黄野.闭合楔形胫骨高位截骨的并发症[J].中华关节外科杂志:电子版, 2016, 10(5): 535-540.
16	Jin C, Song EK, Santoso A, et al. Survival and risk factor analysis of medial open wedge high tibial osteotomy for unicompartment knee osteoarthritis [J]. Arthroscopy, 2020, 36(2): 535-543.
17	Fujisawa Y, Masuhara K, Shiomi SJ. The effect of high tibial osteotomy on osteoarthritis of the knee: an arthroscopic study of 54 knee joints [J]. Orthopedic Clinics of North America, 1979, 10(3): 585-608.
18	Martay JL, Palmer AJ, Bangerter NK, et al. A preliminary modeling investigation into the safe correction zone for high tibial osteotomy [J]. Knee, 2018, 25(2): 286-295.
19	恽常军,钱文杰,王岩峰,等.胫骨高位截骨联合关节镜手术治疗膝关节内侧骨关节炎[J].中华创伤骨科杂志, 2020, 22(9): 808-812.
20	Yoo MJ, Shin YE. Open wedge high tibial osteotomy and combined arthroscopic surgery in severe medial osteoarthritis and varus malalignment: minimum 5-Year results [J]. Knee Surg Relat Res, 2016, 28(4): 270-276.
21	王现海,刘佳超,罗颖,等.关节镜加胫骨高位截骨钢板内固定治疗内翻性膝关节骨关节炎[J].中华关节外科杂志:电子版, 2016, 10(5): 557-561.
22	张启栋,曹光磊,何川,等.《膝关节单髁置换术围手术期管理专家共识》解读[J].中华骨与关节外科杂志, 2023, 16(3): 197-205.
23	李腾,李宝军,何改生,等.单髁置换术治疗膝关节内侧间室骨性关节炎的早期疗效[J].中国医师杂志, 2020, 22(6): 896-900.

组别	例数	年龄（年， ±s）	BMI（kg/m²， ±s）	性别（男/女，例）	侧别（左/右，例）	KOA分级（例）
组别	例数	年龄（年， ±s）	BMI（kg/m²， ±s）	性别（男/女，例）	侧别（左/右，例）	I	Ⅱ	Ⅲ
截骨组	29	59.4±4.2	26.39±4.65	10/19	18/11	4	13	12
单髁组	25	58.9±5.1	25.97±3.90	9/16	16/9	3	13	9
统计值		t=0.624	t=0.112	χ²=0.583	χ²=0.145	χ²=0.431
P值		0.476	0.939	0.413	0.748	0.585

组别	例数	年龄（年， ±s）	BMI（kg/m²， ±s）	性别（男/女，例）	侧别（左/右，例）	KOA分级（例）
组别	例数	年龄（年， ±s）	BMI（kg/m²， ±s）	性别（男/女，例）	侧别（左/右，例）	I	Ⅱ	Ⅲ
截骨组	29	59.4±4.2	26.39±4.65	10/19	18/11	4	13	12
单髁组	25	58.9±5.1	25.97±3.90	9/16	16/9	3	13	9
统计值		t=0.624	t=0.112	χ²=0.583	χ²=0.145	χ²=0.431
P值		0.476	0.939	0.413	0.748	0.585

变量	例数	VAS评分（分）	HHS评分（分）	ROM（°）	股胫角（°）
截骨组	29	0.86±0.92	87.45±4.90	132.83±7.21	175.45±1.27
单髁组	25	1.00±0.96	88.4±6.00	131.68±5.80	168.64±0.76
t值		0.401	0.458	0.474	5.466
P值		0.592	0.531	0.520	0.000

变量	例数	VAS评分（分）	HHS评分（分）	ROM（°）	股胫角（°）
截骨组	29	0.86±0.92	87.45±4.90	132.83±7.21	175.45±1.27
单髁组	25	1.00±0.96	88.4±6.00	131.68±5.80	168.64±0.76
t值		0.401	0.458	0.474	5.466
P值		0.592	0.531	0.520	0.000

组别	例数	VAS评分^ac					F值	P值
组别	例数	治疗前	治疗后1个月	治疗后3个月	治疗后6个月	治疗后12个月	F值	P值
截骨组	29	8.31±1.23	6.00±1.04	4.07±1.13^d	2.38±1.24^de	0.86±0.92^def	543.06^ac	<0.01^ac
单髁组	25	8.36±1.29	6.24±0.93	4.04±1.21^d	2.72±1.21^de	1.00±0.96^def	543.06^ac	<0.01^ac
F值		0.503
P值		0.481
组别	例数	HHS评分 ^bc					F值	P值
组别	例数	治疗前	治疗后1个月	治疗后3个月	治疗后6个月	治疗后12个月	F值	P值
截骨组	29	43.48±7.06	77.38±4.65	78.21±4.10	79.69±5.60^d	87.45±4.90^def	533.18^b	<0.01^bc
单髁组	25	42.68±7.86	77.96±5.77	77.56±8.22	81.60±6.26^de	88.40±6.00^def	533.18^b	<0.01^bc
F值		0.166
P值		0.685

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