Neubauer Markus, Reinberger Eva-Maria, Dammerer Dietmar, Moser Lukas B, Neugebauer Johannes, Gottsauner-Wolf Florian, Nehrer Stefan
Center for Regenerative Medicine and Orthopaedics, University for Continuing Education Krems, Dr. Karl-Dorrek-Str. 30, 3500 Krems, Austria.
Department of Orthopaedics & Traumatology, Karl Landsteiner University of Health Sciences, University Hospital Krems, Mitterweg 10, 3500 Krems, Austria.
J Clin Med. 2023 Aug 19;12(16):5387. doi: 10.3390/jcm12165387.
Knee Osteoarthritis (OA) is a debilitating disease. Initially, the medial compartments are affected in most cases. For this pathology, joint preservation is preferable. Two surgical procedures aim to meet this goal: high-tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA). The aim was to compare clinical and radiological outcomes of HTO versus UKA in patients with unicompartmental, medial OA.
Retrospective case series. A total of 86 (61 UKA, 25 HTO) patients that received either treatment at a single, specialized center were assessed pre-operatively and at a single follow-up examination at 77.13 months (±8.170). The Knee Society Score (KSS), range of motion (ROM), SF36 questionnaire and the Tegner score were used. The Kellgren-Lawrence score was assessed pre- and post-surgically. Survivorship with the endpoint "revision" was assessed.
The UKA group showed significantly better improvements in KSS scores for pain ( < 0.006) and function ( < 0.001). OA progression ( < 0.02) and survivorship ( < 0.018) differed, significantly favoring UKA. ROM, SF36 and Tegner score did not differ significantly.
The presented mid-to long-term data suggest that UKA provides superior results in selected outcomes. Nevertheless, significant differences in the demographics of treatments indicate the challenge of comparing these two treatments.
膝关节骨关节炎（OA）是一种使人衰弱的疾病。最初，大多数病例中内侧间室会受到影响。对于这种病症，保留关节更为可取。有两种外科手术旨在实现这一目标：高位胫骨截骨术（HTO）和单髁膝关节置换术（UKA）。目的是比较HTO与UKA治疗单髁内侧OA患者的临床和放射学结果。
回顾性病例系列研究。共有86例（61例行UKA，25例行HTO）在单一专科中心接受治疗的患者在术前及术后77.13个月（±8.170）进行了一次随访检查时接受评估。使用了膝关节协会评分（KSS）、活动范围（ROM）、SF36问卷和泰格纳评分。术前和术后评估了凯尔格伦-劳伦斯评分。评估了以“翻修”为终点的生存率。
UKA组在KSS疼痛评分（<0.006）和功能评分（<0.001）方面有显著更好的改善。OA进展（<0.02）和生存率（<0.018）存在差异，显著有利于UKA。ROM、SF36和泰格纳评分无显著差异。
所呈现的中长期数据表明，UKA在特定结果方面提供了更好的结果。然而，治疗人群统计学上的显著差异表明比较这两种治疗方法具有挑战性。
