The Early Efficacy Of Open Wedge High Tibial Osteotomy And Unicompartmental Knee Arthroplasty In The Treatment Of Medial Compartment Osteoarthritis Of The Knee Joint

Objective:The early postoperative efficacy of opening wedge high tibial osteotomy(OWHTO)and unicompartmental knee arthroplasty(UKA)in the treatment of medial interstitial osteoarthritis of the knee was compared to provide a reference for the selection of clinical surgical methods.Methods:Perioperative time,intraoperative blood loss,postoperative hospital stay and other indicators were compared and analyzed.Visual Analogue Score(VAS),hospital for special surgery knee Score(HSS),the western Ontario and McMaster universities osteoarthritis index(WOMAC)were used for efficacy analysis at follow-up 6 weeks after surgery and 12 weeks after surgery.Results:All included patients were followed up for more than 3 months.There was no statistically significant difference in general information and preoperative scores(VAS,HSS,WOMAC)between the two groups.No revision cases occurred in the two groups during the follow-up period,and the prosthesis survival rate was good.For the perioperative data,the operative time of the two groups was(121.35 ±21.82 min in UKA group and 125.26±18.52 min in OWHTO group,P=0.551),the intraoperative blood loss was(122.50±48.55 ml in UKA group and 172.11±68.65 ml in OWHTO group,P=0.007),and the postoperative hospitalization days were(6.25±1.12 days in UKA group and 13.26±2.71 days in OWHTO group,P=0.000).The amount of intraoperative blood loss and the length of postoperative hospital stay in the two groups were statistically significant.As for postoperative pain and function scores,VAS scores were 3.05±0.94 and 1.90±0.97 in the UKA group at 6 and 12 weeks after surgery,and 2.84±1.01 and 1.79±0.98 in the OWHTO group at 6 and12 weeks after surgery,respectively.In terms of knee HSS score,the HSS score of the two groups was(83.25±3.04 in the UKA group and 82.57±3.29 in the OWHTOgroup)at the 12-week follow-up after surgery,and the difference between the two groups was not statistically significant(P=0.512).However,the difference between the two groups was statistically significant(74.75±2.71 in the UKA group and 65.36±4.10 in the OWHTO group)at the 6-week follow-up after surgery(P=0.000).In terms of WOMAC function score,there was no statistically significant difference between the two groups(17.25 ± 6.45 in the UKA group and 20.58± 5.32 in the OWHTO group)when followed up 12 weeks after surgery(P=0.088),and there was statistically significant difference between the two groups(28.80±9.88 in the UKA group and 37.95 ± 9.38 in the OWHTO group)when followed up 6 weeks after surgery(P=0.005).Conclusion:Under the condition of strict control of indications,both OWHTO and UKA can significantly relieve knee joint pain and improve knee joint function in patients with medial compartment osteoarthritis of the knee joint.However,the postoperative efficacy of UKA was better than that of OWHTO during the period of hospitalization and during the follow-up 6 weeks after the operation,and the postoperative efficacy of UKA was the same as that of OWHTO during the follow-up 3 months after the operation.The long-term follow-up needs to be further studied.