scholarly journals Functional Outcome of High Tibial Osteotomy in Patients with Medial Compartment Osteoarthritis Using Dynamic Axial Fixator -a prospective study

2020 ◽  
Vol 11 ◽  
pp. S902-S908
Author(s):  
Amit kumar yadav ◽  
Mangal parihar ◽  
Eknath d Pawar ◽  
Divya ahuja ◽  
Sandeep gavhale ◽  
...  
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
A Prospective Study

scholarly journals Proximal Fibular Osteotomy vs high Tibial Osteotomy in medial compartment Osteoarthritis of knee

2021 ◽  
Vol 12 (6) ◽  
pp. 69-74
Author(s):  
Sujay K Mahadik ◽  
Shriansh Pandey ◽  
Neel S Belsare ◽  
Girish S Shinde ◽  
Shrikant B Deshpande
Keyword(s):  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Weight Bearing ◽  
Medial Compartment ◽  
Full Weight Bearing ◽  
Tibial Osteotomy ◽  
Complication Rates ◽  
Medial Compartment Osteoarthritis ◽  
Fibular Osteotomy ◽  
Osteoarthritis Of Knee

Background: Osteoarthritis of knee is one of the common conditions seen in older individuals and known to affect quality of life considerably. It makes it difficult for individuals with knee osteoarthritis to climb stairs, walk long distances, and stand for long time and squatting. In intractable cases not responding to conservative management surgical management such as proximal fibular Osteotomy (PFO) or high tibial Osteotomy (HTO) is routinely done. We conducted this comparative study to analyse the functional outcome of patients who had undergone HTO and PFO for medial compartment osteoarthritis of knee joint. Aims and Objectives: 1) To analyse the functional outcome of patients who had undergone HTO and PFO for medial compartment osteoarthritis of knee joint. 2) To compare complication rates in both the groups. Materials and Methods: A total of 60 patients with medial compartment knee osteoarthritis were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were randomized to 2 groups. Thirty patients undergoing proximal fibular osteotomy (Group A) and 30 patients undergoing high tibial osteotomy (Group B). The patients were followed up for improvements in functional outcome for 12 months. The statistical analysis was done using SSPS 21.0 software and p value less than 0.05 were taken as statistically significant. Results: Mean time for surgery was less for PFO surgery as compared to HTO and the difference was statistically significant. Moreover mean bleeding amount, drainage volume and time required for full weight bearing was low in PFO group as compared to HTO group and the difference was found to be statistically significant (P<0.05). The mean VAS score at the time of presentation in PFO and HTO groups was found to be 4.9 +/- 1.12 and 4.7 +/- 1.02 respectively. A statistically significant reduction in pain was documented at the time of follow up of 4 weeks in both the groups. The functional outcome and complication rates were comparable in both the groups. Conclusion: Proximal fibular osteotomy is a better option as compared to high tibial osteotomy in terms of mean surgery time, mean bleeding amount, drainage volume and time required for full weight bearing. Functional outcome and improvement in VAS were comparable in both the groups.

Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim Mostafa El-Ganzoury ◽  
Zeiad Mohamed Zakaria ◽  
Ahmed Elsayed ◽  
Abd Ellah Elwarwary
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Total Knee

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

scholarly journals EVALUATION OF OUTCOME OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL KNEE OSTEOARTHRITIS

2020 ◽  
pp. 1-4
Author(s):  
R. N. Shewale ◽  
Ketan J. Khatri
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Functional Score ◽  
Tibial Osteotomy ◽  
Knee Score ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy ◽  
The Mean

Background: Osteoarthritis is often found in weight-bearing joints, the knee being the most common site. Most patients of symptomatic osteoarthritis of knee are associated with varus malalignment that is causative or contributory to painful arthritis. Correcting the malalignment of the knee relieves symptoms by transferring the functional load to the unaffected compartment. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. We report the outcome of a simple technique of medial opening wedge high tibial osteotomy in treating the medial compartment osteoarthritis of the knee. Materials and method: A prospective interventional study was carried out over a period of 2 years from November 2017 to October 2019 in a sample size of randomly selected 41 patients having unilateral knee osteoarthritis. All patients after a proper preoperative assessment underwent high tibial osteotomy and the outcome was evaluated using knee society scoring system. Results: The age of the patients ranged from 40 – 65 years with a mean age of 51 years, 13 were males and 28 were females showing female predominance (68.2%). The mean knee score and the mean functional score of the patients before surgery were 60 and 61.95 respectively and post operatively at the end of 6 months the knee score and functional score was 77 and 80.53 respectively. By the end of 6 months out of 41 patients, 12 patients (29.2%) had excellent functional outcome, 18 patients (43.90%) had good functional outcome, 09 patients (21.95%) had fair functional outcome while only 02 patients (04.87%) had poor functional outcome. Conclusions: The present study shows that HTO is a good option in isolated medial compartment OA of knee. Significant increase in the knee score and functional score was found after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Success of high tibial osteotomy relies on appropriate patient selection, proper osteotomy type and precise surgical technique.

Cost-Effectiveness Analysis of Unicompartmental Knee Arthroplasty and High Tibial Osteotomy for Treatment of Medial Compartmental Osteoarthritis

2011 ◽  
Vol 1 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Christopher A Brown ◽  
Tyler S Watters ◽  
Richard C Mather ◽  
Lori A Orlando
Keyword(s):  
Cost Effectiveness ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Decision Model ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Markov Decision ◽  
Markov Decision Model

ABSTRACT Background Interest in unicompartmental knee arthroplasty (UKA) has recently increased in the United States concomitantly with an increase in the prevalence of physiologically active patients presenting with medial compartment osteoarthritis. This study examined the cost-effectiveness of UKA compared with high tibial osteotomy (HTO) in patients with medial compartment osteoarthritis. Methods A Markov decision model was constructed with review of literature to conduct a cost-utility analysis of UKA as compared to HTO in a patient population aged 40 years at the time of surgical intervention. Utility values were assigned to health states annually based on the commonly accepted reference values of 1 being “full health” and 0 being “death”. These values are used to estimate quality-adjusted life years (QALYs). The Markov decision model was used to evaluate the total accumulated costs and effectiveness, measured in QALYs. Results The average cost of the UKA was cheaper by $842 and resulted in a significant incremental effectiveness gain compared to HTO (+ 0.96 QALY). UKA gained 20.05 QALY at a cost-effectiveness (C/E) ratio of $1048/QALY, whereas HTO gained 19.09 QALY at a C/E ratio of $1145/QALY. Conclusion Both UKA and HTO are cost-effective procedures but patients treated with UKA may experience an increased net health benefit over their lifetime. Level of evidence Economic and decision analysis level II.

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