Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12, Changjia Lane, Jingzhong Street, Mianyang, 621000, China.
Eur J Orthop Surg Traumatol. 2024 Jul;34(5):2421-2427. doi: 10.1007/s00590-024-03944-4. Epub 2024 Apr 17.
To compare clinical outcomes of high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) for anterior medial osteoarthritis (AMOA) as well as offer surgical recommendations through age stratification.
Between May 2019 and May 2021, 68 cross-indicated AMOA patients were analyzed. The patients were divided into HTO and UKA groups and further into two age groups of 55-60 and 60-65 years. Additionally, general data, visual analog scale (VAS) score, and Hospital for Special Surgery knee score (HSS) were analyzed.
All the patients were followed up for 18 months. Knee joint HSS significantly improved, and VAS score decreased in both groups (P < 0.05). In the 55-60 age group, HTO showed superior knee HSS at 1 and 3 months (P < 0.05), with no significant difference at 6, 12, and 18 months. HTO had a significantly lower VAS score at one month, and the VAS scores of the two groups decreased gradually with no significant difference. In the 60-65 age group, the UKA group showed superior knee joint HSS at one month, with no significant difference at 3, 6, 12, and 18 months. The UKA group had a significantly lower VAS score at one month, and both groups' VAS scores decreased gradually with no significant difference.
Both methods yield satisfactory results for AMOA cross-indications, improving knee joint function. The observed recovery trends have implications for personalized surgical recommendations, guiding interventions based on age-specific considerations for optimal outcomes in anterior medial osteoarthritis cases.
比较高位胫骨截骨术（HTO）和单髁膝关节置换术（UKA）治疗前内侧骨关节炎（AMOA）的临床效果，并通过年龄分层为手术提供建议。
回顾性分析 2019 年 5 月至 2021 年 5 月间的 68 例交叉指征 AMOA 患者。将患者分为 HTO 组和 UKA 组，并进一步分为 55-60 岁和 60-65 岁两个年龄组。同时分析一般资料、视觉模拟评分（VAS）和美国特种外科医院膝关节评分（HSS）。
所有患者均获得 18 个月随访。两组患者膝关节 HSS 评分均显著提高，VAS 评分均降低（P<0.05）。在 55-60 岁年龄组，HTO 在术后 1 和 3 个月时膝关节 HSS 评分较高（P<0.05），而在术后 6、12 和 18 个月时无显著差异。HTO 在术后 1 个月时 VAS 评分较低，两组 VAS 评分逐渐降低，无显著差异。在 60-65 岁年龄组，UKA 组在术后 1 个月时膝关节 HSS 评分较高，而在术后 3、6、12 和 18 个月时无显著差异。UKA 组在术后 1 个月时 VAS 评分较低，两组 VAS 评分逐渐降低，无显著差异。
两种方法均能有效改善 AMOA 交叉指征患者膝关节功能，获得满意疗效。观察到的恢复趋势提示应根据年龄制定个性化手术建议，针对前内侧骨关节炎患者的具体情况进行干预，以获得最佳效果。
