Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review.
Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review.
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DOI：
10.1186/s13018-017-0552-9
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发表时间：
2017-03-28
影响因子：
2.6
通讯作者：
Wu L
中科院分区：
文献类型：
--
作者：
Santoso MB;Wu L
高胫骨截骨术（HTO）或单室膝关节置换术（UKA）对治疗单室膝关节骨性关节炎更有益，但仍有争议。本研究的目的是比较两种手术的功能结果、膝关节评分、活动水平和并发症。我们对1982年8月至2017年1月期间发表的文献进行了系统回顾。15篇报告了三个前瞻性随机试验的论文纳入了荟萃分析。两组在自由行走（速度）、膝关节评分、对侧或髌股膝关节恶化、翻修率和全膝关节置换术方面无显著差异。然而，与HTO相比，UKA在功能结果、疼痛评估和并发症方面产生了更好的结果，尽管接受HTO的患者往往有稍微更好的活动范围。外翻HTO为年轻患者提供了更好的身体活动，而UKA由于康复时间短，功能恢复快，更适合老年患者。虽然UKA患者倾向于改善整体长期预后，这可能是由于准确的适应症和患者选择，两种治疗方案都产生了令人满意的结果。因此，我们不能断定哪一种方法更好。
Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a meta-analysis. No significant difference between the two groups was noted with respect to free walking (velocity), knee score, deterioration of the contralateral or patellofemoral knee, or revision rate and total knee arthroplasty. However, UKA produced better outcomes compared to HTO in terms of the functional results, pain assessment, and complications, although patients who underwent HTO tended to have slightly better range of motion. Valgus HTO provides better physical activity for younger patients whereas UKA is more suitable for older patients due to shorter rehabilitation time and faster functional recovery. Although UKA patients tended to have improved overall long-term outcomes, which may be due to accurate indications and patient selection, both treatment options yielded pleasing results. Therefore, we are unable to conclude that either method is superior.