Clinical study of high tibial osteotomy combined with microfracture in treatment of medial unicompartmental knee osteoarthritis

Abstract

Objective To explore the clinical effect of high tibial osteotomy(HTO) combined with arthroscopic microfracture in the treatment of medial unicompartmental knee osteoarthritis. Methods From October 2014 to October 2016, 58 cases with medial unicompartmental knee osteoarthritis were enrolled in the study, who were treated in the first department of orthopaedics of the second affiliated hospital of Xi'an Jiaotong University. Patients with normal range of motion and undergone conservative therapy for six months were included. Patients with inflammatory arthritis and lateral knee osteoarthritis were excluded. All the cases were randomly divided into two groups, 29 cases with HTO combined with arthroscopic microfracture (microfracture group), 29 cases with HTO combined with arthroscopic debridment (debridment group). Visual analogue scale(VAS), Hospital for Special Surgery(HSS), and International Knee Documentation Committee(IKDC)scores were used to compare the two groups before and 12 months after surgery. According to the full-length X-ray film of both lower limbs in weight-bearing position, medial proximal tibial angle(MPTA)and femur-tibia angle(FTA)were measured and used to compare the two groups before and 12 months after surgery. Paired t test and chi-square test were used for statistical analysis. Results All the patients were followed up for (13.5±1.6) months. The VAS, HSS and IKDC scores of the two groups at 12 months after surgery were improved comparing with the scores before surgery. The score differences of the microfracture group before and 12 months after surgery were superior to the debridment group , the difference was statistically significant (VAS t =2.316, HSS t =4.063, IKDC t =3.121, all P 0.05). Conclusion HTO combined with arthroscopic microfracture or debridement can achieve good clinical efficacy in the treatment of medial unicompartmental knee osteoarthritis, and the microfracture has better clinical efficacy, which may be related to the existence of better cartilage repair, and is worthy of clinical promotion. Key words: Tibia; Osteotomy; Arthroscopy; Osteoarthritis