Comparison of pain levels and ROM between knee arthroplasty and high tibial osteotomy

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Created On: 27/12/2022

A systematic overview of meta-analyses was conducted in order to summarize the result of previously published meta-analysis on high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA).

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Key take away

Unicompartmental knee arthroplasty exhibited lower pain scores but inferior postoperative range of motion when compared to high tibial osteotomy.

Background

Method

The standards set out by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 (PRISMA 2020) were applied. For meta-analyses contrasting UKA with HTO, a literature search was carried out in the Cochrane Database of Systematic Reviews, the Web of Science, PubMed, and Embase. Screening of literature, extraction of data, and article quality appraisal were carried out.

Result

Overall, 10 meta-analyses were included, and the outcomes of different investigations varied. Notably, 5 out of 7 meta-analyses revealed that for UKA, there were more individuals with excellent or good functional outcomes than for HTO. UKA was shown to be linked with decreased pain scores in all three meta-analyses, and UKA showed non-inferiority to HTO in all six trials that included range of motion (ROM) analysis.

In 4 out of 8 meta-analysis, it was discovered that the overall complication rates were reduced in UKA. Only three of the ten meta-analysis revealed decreased revision rates for UKA. In addition, the complication rate and revision rate of UKA in the subgroup assessment were comparable to opening-wedge HTO but were substantially reduced than closing-wedge HTO.

Conclusion

UKA was linked to lower pain scores but less favorable postoperative ROM than HTO. Regarding whether UKA produced higher knee function scores and lower complication or revision rates than HTO, the findings were unclear. Treatment of people with osteoarthritis requires careful patient selection and accurate indication identification.

Source:

Journal of Orthopedic Surgery and Research

Link:

https://pubmed.ncbi.nlm.nih.gov/36153554/

Article:

Unicompartmental knee arthroplasty is associated with lower pain levels but inferior range of motion, compared with high tibial osteotomy: a systematic overview of meta-analyses