Comparison Of Early Efficacy Between OWHTO And UKA In The Treatment Of Medial Unicompartmental Osteoarthritis Of The Knee Joint

Objective:The purpose of this study is to compare the efficacy of OWHTO and UKA in the treatment of medial unicompartmental osteoarthritis of the knee with tibial deformity.Methods:Patients with medial Unicompartmental osteoarthritis of the knee combined with tibial deformity admitted to Suining Central Hospital from January 2016 to January 2020 were retrospectively analyzed.Those patients underwent Unicompartmental Knee Arthroplasty(UKA)or medial wedge high tibial osteotomy(OWHTO).The overt blood loss,operation time,postoperative hospital stay,Lysholm knee function score,Oxford knee score(OKS)and femorotibial angle were compared between the two groups.Results:41 patients were followed up for more than 1 year,including 21 in the UKA group and 20 in the OWHTO group.There was no statistically significant difference in the general data,preoperative knee function score and femorotibial angle between the two groups(P>0.05).Comparison of the perioperative period:There was statistical difference of dominant blood loss between the two groups(246.2±24.4 ml in UKA group and 356.7±30.3 ml in OWHTO group,P<0.05).There was statistical difference of operation time between the two groups(80.6±7.5 min in UKA group and 75.4± 7.2 min in OWHTO group,P<0.05).There was no statistical difference of hospital stay after operation between the two groups(6.8± 1.6 days in UKA group and 7.4 ± 1.8 days in OWHTO group,P>0.05.Comparison of postoperative efficacy:The Lysholm knee function score increased at 3 months,6 months and 1 year after surgery,while the OKS score decreased.The difference was statistically significant(P<0.05).Lysholm knee function score increased and OKS score decreased 3 months,6 months and 1 year after operation,with statistical significance(P<0.05).At 3 and 6 months follow-up after surgery,the Lysholm knee function score and OKS score in the UKA group were better than those in the OWHTO group,and the difference was statistically significant(P<0.05).At 1 year after operation,there was no significant difference in Lysholm knee function score and OKS score between the two groups(P>0.05).The postoperative femorotibial angle in the two groups was reduced compared with that before operation,and the difference had statistical significance(P<0.05).OWHTO was superior to UKA in correction of femorotibial angle,and the difference was statistically significant(P<0.05).During the follow-up period,One patient in the UKA group had dislocation of the polyethylene liner at 1 year after surgery,and one patient had postoperative numbness around the surgical incision and anterior medial aspect of the lower leg.No relevant complications were observed in the OWHTO group.Conclusion:For patients with medial unicompartmental osteoarthritis of the knee combined with tibial deformity,both medial unicompartmental knee arthroplasty and open wedge high tibial osteotomy can achieve satisfactory results in the early postoperative period.Functional improvement was more rapid after UKA,and HTO could better correct the lower limb alignment.