High Tibial Osteotomy versus Unicompartmental Knee Arthroplasty for Medial Compartment Arthrosis of the Knee A Systematic Review of Literature

Abstract

Background: UKA and HTO are both treatment alternatives for medial compartmental OA with similar indication criteria and have been called the ‘strange couple’ by Dettoni. Age and activity are known to be the major factors in deciding the treatment method. The ideal indication for HTO is young and active patients, whereas UKA is ideal for the patients >60 years old and with low activity demand. These points were taken into consideration when determining the surgical procedure, and it was explained that HTO might be more suitable for active patients. Objective: A systematic review conducted to evaluate both HTO and UKA for treatment of unicompartmental knee OA concerning the functional outcomes, complications, and subsequent revisions to TKA after failed HTO or UKA. Methods: This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Data Sources: A Fterexclusion of duplicates, irrelevant titles, irrelevant abstracts, papers with other modalities of treatment other than UKA and HTO for UKOA like nonsurgical methods, papers with number of patients less than five or follow up period less than half a year. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion: UKA offers a safe and efficient alternative to osteoarthritis reduced postoperative pain, less postoperative complication, and revision. The 2 surgical techniques showed satisfactory function results for the patients; however, the HTO group achieved superior ROM compared to the UKA group. HTO may be suitable for patients with high activity requirements. Treatment options should be carefully considered for each patient in accordance with their age, body mass index, grade of osteoarthritis, and patients’ activity levels. Keywords: High Tibial Osteotomy; Unicompartmental Knee Arthroplasty; Compartment Arthrosis of the Knee