High tibial osteotomy combined with arthroscopic microfracture to treat the single compartment osteoarthritis of the medial of knee joint

Abstract

Objective To study the clinical effect of high tibial osteotomy combined with arthroscopic microfracture in the treatment of the single compartment osteoarthritis of the medial compartment lesions of knee joint. Methods Sixty patients with the single compartment osteoarthritis of the medial compartment lesions of knee joint were diagnosed from January 2012 to December 2014 in Chifeng Municipal Hospital of Inner Mongolia Autonomous Region, which were divided into 3 groups according to the simple random sampling method. The patients with high tibial osteotomy were established as the high tibial osteotomy group (osteotomy group), the patients with arthroscopic microfracture surgery were treated as arthroscopic microfracture group (microfracture group), the patients with high tibial osteotomy combined with arthroscopic microfracture were established as high tibial osteotomy combined with arthroscopic microfracture surgery group (combined group), and each group were 20 cases. Evaluation of 3 groups of patients before operation, 12 months after surgery, the visual analogue score (VAS), the American Knee Association (AKS)score, the American West Lake and McMaster University Osteoarthritis Index (WOMAC) score were used to measure anterior and posterior tibial proximal medial angle (MPTA) and femoral shank angle, and preoperative and postoperative knee joint scoring (HSS). The data were processed with t test, analysis of variance and SNK test. Results The scores of VAS, AKS, WOMAC and HSS for 12 months after operation were significantly improved in the 3 groups and the differences were statistically significant (with P values below 0.05). There were no statistically significant differences between MPTA and femoral shank angles before and after operation in microfracture group (with P values above 0.05). The differences between the preoperative and postoperative of VAS, AKS score, WOMAC score, HSS score and MPTA, femoral shank angle in combined group were (4.9±0.6) points, (20.1±5.3) points, (62.1±7.4) points, (24.9±11.7) points, (11.2±2.1) °, (24.2±2.4) °, which were significantly improved compared with the osteotomy group and the microfracture group(with P values below 0.05). Conclusions Three kinds of surgical procedures for the treatment of the single compartment osteoarthritis of the medial knee joint can improve the symptoms and signs of the patients in the short term. However, high tibial osteotomy combined with arthroscopic microfracture treatment can deal with intra articular lesions and improve the biological lines of the lower limbs, and the postoperative effect is significantly better than others. Key words: Tibia; Osteotomy; Arthroscopy; Osteoarthritis, Knee