Comparison of Open Wedge High Tibial Osteotomy versus Unicondylar Knee Replacement for Medial Knee Osteoarthritis

Abstract

Introduction: Medial knee osteoarthritis is a source of debilitating pain. Varus malalignment is associated with a 4-fold increase in unicompartmental osteoarthritis. Current non-surgical treatments include patient education, weight loss, analgesics. Two contemporary surgical treatment options for medial knee osteoarthritis are available and each procedure has its merits. These are based on different principles: high tibial osteotomy (OW- HTO) where correction of knee angular deformity with slight valgus overcorrection is the goal and unicondylar knee replacement (UKA) surgery’s aim in replacing damaged articular surface. Aim: To review clinical outcomes of two matched populations between open wedge high tibial osteotomy (OW-HTO) and unicondylar knee (UKA). Material and Methods: This was a prospective study of two matched populations at two different centres, employing different techniques for managing medial knee compartment osteoarthritis. The OW-HTO centre had recruited 19 patients over February 2012 to December 2013. The TomoFix® knee osteotomy. The unicondylar knee replacement (UKA) centre had 22 patients over June 2012 to August 2013 and used the Oxford™ partial knee system in these operations. Conclusion: In conclusion, this study shows that open wedge high tibial osteotomy and unicondylar knee replacements have no significant differences in oxford scores at 6 weeks and 6 months.