| Objective:Knee osteoarthritis is the most common osteoarthritis,and the incidence rate of the elderly is high.Osteoarthritis of the knee joint is mainly caused by the degeneration of cartilage and subchondral bone.In the early stage of the disease,a large number of patients are only accompanied by the disorder and degeneration of the medial compartment,and the symptoms such as pain are mainly concentrated in the medial compartment,while the joint surfaces of the other two compartments often remain relatively healthy,which is clinically known as osteoarthritis of the medial compartment of the knee joint.The main treatment goal of osteoarthritis of the medial compartment of the knee joint is to relieve pain,restore function,and improve the quality of life of patients.At present,there are still disputes about the choice of knee preservation surgery for medial compartment osteoarthritis of the knee.Among them,the common methods of knee preservation surgery include high tibial osteotomy and single condylar replacement.The purpose of this article is to make a comprehensive analysis of the high-quality literature published at home and abroad that compares the clinical effects of high tibial osteotomy(HTO)and unicondylar knee arthroplasty(UKA)in the treatment of osteoarthritis of the medial compartment of the knee joint.Provide more accurate and more suitable options for patients with medial compartment osteoarthritis who require knee protection surgery.Methods:Medline,Pubmed,Chinese Science and Technology Journal Database(CNKI),Vip database and other databases were searched by computer.Manually search relevant Chinese and English orthopedic journals and conference papers.The search deadline is May 2022.Key words: high tibial osteotomy;Single condylar replacement;high tibial osteotomy;uncompartmental knee arthroplasty;unicondylar knee arthroplasty。Retrieve the literature on high tibial osteotomy(HTO)and unicondylar knee arthroplasty(UKA)for the treatment of medial compartment osteoarthritis of the knee joint,including the number of excellent cases,the number of revision cases,the number of complications,the knee joint score,the knee joint flexion range of motion,the tibiofemoral angle and other data,select the literature that meets the inclusion criteria and conduct the corresponding quality score.Intensively read the literature and extract the required clinical data,and use the Revman5.4 software provided by Chochrane collaboration network to conduct a meta-analysis of the research results of the included literature,and then conduct a heterogeneity test of the data.Results:A total of 18 articles were included,with a total of 1292 patients and 1345 knee joint samples.There were 653 cases in the high tibial osteotomy(HTO)group and 692 cases in the unicondylar replacement(UKA)group.There was no significant difference between the two groups in the knee joint KSS score [WDM=-1.25,95% CI(-10.15,7.65)],knee joint HSS score [WDM=-0.69,95% CI(-1.81,0.44)],postoperative complications [WDM=1.35,95% CI(0.75,2.42)],postoperative excellent and good rate [WDM=0.70,95% CI(0.19,2.58)],and revision rate [WDM=0.81,95% CI(0.20,3.21)](P>0.05).There were significant differences between the two groups in the knee Lysholm score [WDM=-0.94,95% CI(-1.69,-0.19)],knee flexion activity after operation [WDM=5.11,95% CI(1.71,8.52)],and tibiofemoral angle after operation[WDM=-3.52,95% CI(-6.18,-0.85)](P<0.05).The Lysholm score in UKA group is better than that in HTO group,while the knee flexion and motion and the tibiofemoral angle after operation in HTO group are better than that in UKA group.Conclusion:Based on the available data,in the comparison of the clinical effects of the two types of surgery in different periods,the score of knee joint movement ability after unicondylar knee arthroplasty is higher,while the knee joint flexion activity and tibiofemoral angle after high tibial osteotomy have more advantages.Patients can choose more appropriate surgical methods according to their own needs. |
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