Department of Orthopedic Surgery, Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, People's Republic of China.
Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China.
J Arthroplasty. 2018 Mar;33(3):952-959. doi: 10.1016/j.arth.2017.10.025. Epub 2017 Dec 2.
Prior studies have compared unicompartmental knee arthroplasty (UKA) with high tibial osteotomy (HTO) suggesting that both procedures had good clinical outcomes. However, which treatment is more beneficial for unicompartmental knee osteoarthritis is still a controversy. The purpose of our study is to obtain postoperative outcomes of revision rate, complications, function results, range of motion (ROM), and pain between the 2 procedures.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and study protocol was published online at PROSPERO under registration number CRD42016049316. We searched the databases MEDLINE, EMBASE, Cochrane Library, and Web of Science up to May 2017. Articles that directly compared postoperative outcomes of UKA to HTO were included.
A total of 10 comparative studies were included in our meta-analysis. UKA patients showed less revision rate, less complications, and less postoperative pain than HTO patients; however, HTO patients obtained more ROM. No significant difference was observed between the group accruing to the knee function scores and excellent/good surgical results.
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.
先前的研究比较了单髁膝关节置换术（UKA）与胫骨高位截骨术（HTO），表明这两种手术都有良好的临床效果。然而，对于单间室膝关节骨关节炎，哪种治疗方法更有益，仍存在争议。我们的研究目的是获得两种手术的术后翻修率、并发症、功能结果、关节活动度（ROM）和疼痛的结果。
遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，并在 PROSPERO 注册编号 CRD42016049316 下在线发表研究方案。我们检索了 MEDLINE、EMBASE、Cochrane 图书馆和 Web of Science 数据库，检索时间截至 2017 年 5 月。纳入直接比较 UKA 与 HTO 术后结果的比较研究。
我们的荟萃分析共纳入 10 项比较研究。UKA 患者的翻修率、并发症和术后疼痛均低于 HTO 患者；然而，HTO 患者的 ROM 更大。在膝关节功能评分和优秀/良好手术结果方面，两组之间无显著差异。
UKA 为膝关节骨关节炎提供了一种安全有效的替代治疗方法，可减少术后疼痛、减少术后并发症和翻修。两种手术技术为患者提供了满意的功能结果；然而，与 UKA 组相比，HTO 组的 ROM 更好。HTO 可能适用于活动要求较高的患者。应根据患者的年龄、体重指数、骨关节炎程度和患者的活动水平，为每位患者仔细考虑治疗选择。
