Meta Analysis Of Total Knee Arthroplasty After High Tibial Osteotomy And Unicompartmental Knee Arthroplasty

Objective:The meta analysis method was used to systematically evaluate the total knee arthroplasty(TKA)after high tibial osteotomy(HTO)and unicompartmental knee arthroplasty(UKA).Methods:Medline,embase,ovid,cochrane,web of science and other databases were search ed by computer.All the literatures about the of total knee arthroplasty(TKA)after high tibial osteotomy(HTO)and after unicompartmental knee arthroplasty(UKA)were searched from the database to January 2020.The literatures that met the incl usion criteria were screened strictly,and the data and information of the selected li teratures were extracted and input into RevMan5.3 software.The included results w ere analyzed by meta.Results:A total of 7 retrospective cohort studies were included,including 3569 patients(3578 knees),including 2193 cases(2197 knees)of total knee arthroplasty(TKA)after high tibial osteotomy(HTO)and 1376 cases(1381 knees)of total knee arth roplasty(TKA)after unicompartmental knee arthroplasty(UKA).The analysis show ed that(TKA)after high tibial osteotomy(HTO)had a higher incidence of posto perative complications(RR=1.55,95%CI:1.08~2.23,P=0.02),higher knee score(MD=3.53,95%CI:0.16~6.91,P=0.04)and lower revision rate during follow-up(RR=0.77,95%CI:0.61~0.96,P=0.02)than(TKA)after unicompartmental knee arthroplasty(U KA).There was no significant difference in the time of operation(MD=-1.56,95%C I:-11.43~8.32,P=0.76),the range of motion of knee joint(MD=-0.12,95%CI:-3.74~3.5,P=0.95)and the incidence of postoperative infection(RR=1.72,95%CI:0.81~3.62,P=0.16).Conclusion:Through the comparative analysis of the clinical effects of total knee arthropl asty(TKA)after high tibial osteotomy(HTO)and unicompartmental knee arthropl asty(UKA),it is found that there are difficulties in the operation of TKA in both groups.The operation time,postoperative range of motion of knee joint and the in cidence of postoperative infection were similar between the two groups,while the patients who had previously received high tibial osteotomy(HTO)had a higher in cidence of postoperative complications,better knee joint function and lower revisio n rate during follow-up.