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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.01.2013 | Knee

The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis

verfasst von: Gunter Spahn, Gunther O. Hofmann, Lars Victor von Engelhardt, Mengxia Li, Henning Neubauer, Hans Michael Klinger

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2013

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Abstract

Purpose

Both high tibial valgus osteotomy (HTO) and unicompartmental medial knee arthroplasty (UKA) are established methods for the treatment for moderate stages of OA. This is the first global meta-analysis to compare the long-term effects of both methods regarding survival, outcomes and complications of total arthroplasty.

Methods

Literature research was performed using established medical databases: MEDLINE (via PubMed), EMBASE (via OVID) and the Cochrane register. Criteria for inclusion were as follows: English or German papers, a clinical trial with a clear description of survival, an outcome evaluation using a well-described knee score and a follow-up >5 years. Statistical analysis was performed using the special meta-analysis software called “Comprehensive Meta Analysis” (version 2.0; Biostat, Englewood, NJ, USA).

Results

Final meta-analysis after the full-text review included 46 studies about valgus HTO and 43 studies about medial UKA. There were no significant differences between valgus HTO and medial UKA in terms of the number of total required replacements. After a 5- to 8-year follow-up, 91.0% of the valgus HTO patients and 91.5% of medial UKA patients did not need a total replacement. This value was 84.4% for valgus HTOs and 86.9% for medial UKAs after a 9- to 12-year follow-up. Mean survival time to TKA was 9.7 years after valgus HTO and 9.2 years after medial UKA. Clinical outcome was significantly better after medial UKA in a 5- to 12-year follow-up. After more than 12 years, results were comparable in both groups. No significant differences were seen in the complication rates.

Conclusions

This meta-analysis aimed to find the advantages and disadvantages of two established methods for the treatment for medial compartment knee osteoarthritis. Valgus HTO is more appropriate for younger patients who accept a slight decrease in their physical activity. Medial UKA is appropriate for older patients obtaining sufficient pain relief but with reduced physical activity.

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Titel: The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis
verfasst von: Gunter Spahn
Gunther O. Hofmann
Lars Victor von Engelhardt
Mengxia Li
Henning Neubauer
Hans Michael Klinger
Publikationsdatum: 01.01.2013
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2013
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1751-2

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The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis

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