Department of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China.
Department of Orthopedic Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China.
J Orthop Surg Res. 2024 Sep 28;19(1):587. doi: 10.1186/s13018-024-05080-5.
There is growing evidence that simultaneous bilateral open wedge high tibial osteotomy(SBOWHTO) and simultaneous bilateral unicompartmental knee arthroplasty(SBUKA) is an effective surgical treatment for bilateral medial knee osteoarthritis (MKOA). However, which intervention is more beneficial for bilateral MKOA patients remains unknown. Therefore, the aim of this study was to compare the effectiveness of these two strategies through early clinical outcomes, complication rates, and prosthetic survival.
The clinical data of 60 patients with bilateral MKOA admitted to the Affiliated Hospital of Qingdao University from January 2018 to December 2022 were retrospectively analyzed, and they were divided into SBOWHTO group (n = 28) and SBUKA group (n = 32) according to different treatment methods. Clinical relevant indexes, Hospital for Special Surgery (HSS) score, Knee Society Knee (KSS) score, range of motion(ROM), postoperative complications and prosthetic survival rate were compared between the two groups.
Patients in the SBOWHTO group were followed up for 27 to 50 months, with an average of (37.18 ± 6.84) months. Patients in the SBUKA group were followed up for 24 to 59 months, with an average of (39.38 ± 9.74) months. There were no significant differences in postoperative KSS, HSS and ROM between SBOWHTO group and SBUKA group (p > 0.05). There was no significant difference in complication rate between the two groups (p = 0.721). There was no significant difference in prosthetic survival rate (p = 0.622) and prosthetic survival curve (χ2 = 0.546, p = 0.46) between the two groups.
This study compared early clinical outcomes, complication rates, and prosthesis retention rates after SBOWHTO and SBUKA, and found that the early clinical benefits of SBOWHTO and SBUKA were comparable in patients with bilateral MKOA.
越来越多的证据表明，双侧同期开放楔形胫骨高位截骨术（SBOWHTO）联合双侧单髁膝关节置换术（SBUKA）是治疗双侧内侧膝关节骨关节炎（MKOA）的有效手术治疗方法。然而，哪种干预措施对双侧 MKOA 患者更有益仍不清楚。因此，本研究旨在通过早期临床结果、并发症发生率和假体生存率比较这两种策略的效果。
回顾性分析 2018 年 1 月至 2022 年 12 月青岛大学附属医院收治的 60 例双侧 MKOA 患者的临床资料，根据治疗方法不同分为 SBOWHTO 组（n=28）和 SBUKA 组（n=32）。比较两组患者的临床相关指标、美国特种外科医院（HSS）评分、膝关节协会膝关节评分（KSS）、关节活动度（ROM）、术后并发症和假体生存率。
SBOWHTO 组患者随访 2750 个月，平均（37.18±6.84）个月；SBUKA 组患者随访 2459 个月，平均（39.38±9.74）个月。SBOWHTO 组与 SBUKA 组术后 KSS、HSS 和 ROM 比较差异无统计学意义（p>0.05）。两组患者并发症发生率比较差异无统计学意义（p=0.721）。两组患者假体生存率比较差异无统计学意义（p=0.622），假体生存曲线比较差异无统计学意义（χ2=0.546，p=0.46）。
本研究比较了 SBOWHTO 和 SBUKA 治疗双侧 MKOA 患者的早期临床结果、并发症发生率和假体保留率，发现双侧同期开放楔形胫骨高位截骨术和单髁膝关节置换术在双侧内侧膝关节骨关节炎患者中的早期临床获益相当。
