High tibial osteotomy versus unicompartmental knee arthroplasty in advanced medial compartmental knee arthrosis: A comparative study with propensity score matched analysis.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 4. Arch Orthop Trauma Surg. 2024 Sep;144(9):4095-4100. doi: 10.1007/s00402-024-05302-9. Epub 2024 Apr 17. Clinical and functional outcomes of TKA after HTO or UKA: a New Zealand Joint Registry Study. Lee J(1), Tay ML(2), Frampton CM(3), Young SW(2)(4). Author information: (1)Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand. jaehalee24@gmail.com. (2)Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand. (3)Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand. (4)Department of Surgery, Faculty of Medical and Health Sciences (FMHS), University of Auckland, Auckland, New Zealand. INTRODUCTION: Surgical options for patients with unicompartmental knee osteoarthritis include high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA). When managing younger patients with a higher chance of further surgery, the outcome of any subsequent conversion to total knee arthroplasty (TKA) also needs to be considered. The aim of this study was to compare implant survivorship and patient-reported outcomes for patients undergoing TKA after previous HTO or UKA, with comparisons for age, gender and comorbidities. METHODS: Revision risk and 6-month Oxford Knee Scores (OKS) from the New Zealand Joint Registry were compared for patients who underwent TKA after HTO (HTO-TKA; n = 1556) or UKA (UKA-TKA; n = 965) between 1999 and 2019, with a comparison group of primary TKA (n = 110,948). Mean follow-up was 8.2 years. RESULTS: Adjusted revision risk was similar for HTO-TKA and UKA-TKA groups (hazard ratio (HR) 1.04, p = 0.84); and risk for both groups were higher than primary TKA (HTO-TKA HR 1.45, p = 0.002; UKA-TKA HR 1.51, p = 0.01). Overall adjusted mean OKS at 6 months for HTO-TKA (36.2) was similar to primary TKA (36.8, p = 0.23); and both were higher than UKA-TKA (34.2, p