Unicompartmental Knee Arthroplasty Versus High Tibial Osteotomy For Knee Osteoarthritis:a Meta-analysis

Objective:To compare the clinical outcomes of unicompartmental knee arthroplasty(UKA)versus high tibial osteotomy(HTO)for knee osteoarthritis using a meta-analysis.Methods:Related literature were collected by computerized search of online databases,including PubMed,web of science,Medline,Cochrane library,CNKI,CBM and so on,from the establishment to November 2017.In addition,manual search on Chinese medical journals in recent five years was conducted.The papers that reported randomized controlled trials(RCTs)of UKA versus HTO for knee osteoarthritis were enrolled in this study.Two investigators individually assessed the risk bias of each trial by the Cochrane 5.1.0.Each outcome data was subsequently collected and inputted into Revman 5.3 software for a meta-analysis.Results:A total of 18 clinical trials involving 1416 patients were enrolled,including 733 patients of UKA and 683 of HTO.By comparison,the UKA proved significantly higher excellent rate of postoperative joint function(OR=2.57,95%CI 1.68-3.93,P<0.001),significantly higher normal walking velocity(OR=0.05,95%CI 0.00-0.11,P=0.003),but a significantly lower postoperative complication rate(OR=0.38,95%CI 0.20-0.70,P=0.002),significantly lower postoperative revision rate(OR=0.39,95%CI 0.25--0.60,P<0.001)than the HTO.Conclusion:Unicompartmental knee arthroplasty is superior to high tibial osteotomy with higher excellent rate of knee joint function and postoperative normal walking velocity,whereas lower complications and revision rate than the latter.