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Open-wedge high tibial osteotomy versus unicompartmental knee arthroplasty: no difference in progression of patellofemoral joint arthritis

  • Kwang-Jun Oh
  • Young Chan Kim
  • Jong Seong Lee
  • Yong Suk Chang
  • Gautam M. Shetty
  • Kyung Wook Nha
Knee

Abstract

Purpose

The purpose of this retrospective comparative study was to evaluate and compare, radiographically and clinically, progression of osteoarthritis (OA) in the patellofemoral (PF) compartment after open-wedge high tibial osteotomy (OWHTO), and unicompartmental knee arthroplasty (UKA) over a minimum follow-up of 5 years.

Methods

In this study, 42 knees in an OWHTO group were compared with 59 knees in a UKA group in terms of radiographic parameters, such as the grading system for OA progression in the PF compartment, and clinical parameters, such as the PF pain and function scores over a minimum follow-up of 5 years.

Results

There was no significant difference of OA progression in the PF compartment between the two groups on knee radiography. Compared with the preoperative grades, the UKA group showed significant progression of OA in the medial PF compartment at the final follow-up, whereas the medial PF compartment showed significant stepwise progression by only one grade when compared to the OWHTO group. The PF pain and function scores showed no statistical differences between the two groups at the final follow-up, regardless of OA progression.

Conclusions

There was no significant difference between OWHTO and UKA in terms of progression of OA in the PF compartment or deterioration of PF function score over a minimum follow-up of 5 years. However, the medial PF compartment of the UKA group was minimal, and worsened or progressed by only one grade.

Level of evidence

III.

Keywords

Patellofemoral osteoarthritis High tibial osteotomy Unicompartmental knee arthroplasty 

Notes

Acknowledgements

This study was supported by Konkuk University.

References

  1. 1.
    Akizuki S, Mueller JK, Horiuchi H, Matsunaga D, Shibakawa A, Komistek RD (2009) In vivo determination of kinematics for subjects having a Zimmer Unicompartmental High Flex Knee System. J Arthroplasty 24(6):963–971CrossRefPubMedGoogle Scholar
  2. 2.
    Berger RA, Meneghini RM, Sheinkop MB, Delia Valle CJ, Jacobs JJ, Rosenberg AG, Galante JO (2004) The progression of patellofemoral arthrosis after medial unicompartmental replacement. Results at 11 to 15 years. Clin Orthop Rel Res (428):92–99CrossRefGoogle Scholar
  3. 3.
    Bito H, Takeuchi R, Kumagai K et al (2010) Opening wedge high tibial osteotomy affects both the lateral patellar tilt and patellar height. Knee Surg Sports Traumatol Arthrosc 18(7):955–960CrossRefPubMedGoogle Scholar
  4. 4.
    Bode G, von Heyden J, Pestka J, Schmal H, Salzmann G, Südkamp N, Niemeyer P (2015) Prospective 5-year survival rate data following open-wedge valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23(7):1949–1955CrossRefPubMedGoogle Scholar
  5. 5.
    Bonasia DE, Governale G, Spolaore S, Rossi R, Amendola A (2014) High tibial osteotomy. Curr Rev Musculoskelet Med 7(4):292–301CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Broughton NS, Newman JH, Baily RA (1986) Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5–10 years’ follow-up. J Bone Joint Surg Br 68(3):447–452PubMedGoogle Scholar
  7. 7.
    Chae DJ, Shetty GM, Lee DB, Choi HW, Han SB, Nha KW (2008) Tibial slope and patellar height after opening wedge high tibia osteotomy using autologous tricortical iliac bone graft. Knee 15(2):128–133CrossRefPubMedGoogle Scholar
  8. 8.
    Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R (2010) High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J 30:131–140PubMedPubMedCentralGoogle Scholar
  9. 9.
    Ferruzzi A, Buda R, Cavallo M, Timoncini A, Natali S, Giannini S (2014) Cartilage repair procedures associated with high tibial osteotomy in varus knees: clinical results at 11 years’ follow-up. Knee 21(2):445–450CrossRefPubMedGoogle Scholar
  10. 10.
    Fu D, Li G, Chen K, Zhao Y, Hua Y, Cai Z (2013) Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty 28(5):759–765CrossRefPubMedGoogle Scholar
  11. 11.
    Gaasbeek R, Welsing R, Barink M, Verdonschot N, van Kampen A (2007) The influence of open and closed high tibial osteotomy on dynamic patellar tracking: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 15(8):978–984CrossRefPubMedGoogle Scholar
  12. 12.
    Han SB, Lee DH, Shetty GM, Chae DJ, Song JG, Nha KW (2013) A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc 21(1):90–95CrossRefPubMedGoogle Scholar
  13. 13.
    Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354CrossRefPubMedGoogle Scholar
  14. 14.
    Karamitev SS, Stavrev VP, Chifligarov AG (2014) Comparative analysis of the results obtained after unicondylar knee arthroplasty and high tibial osteotomy in isolated gonarthrosis. Folia Med (Plovdiv) 56(1):11–19Google Scholar
  15. 15.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Kim TH, Sobti A, Lee SH, Lee JS, Oh KJ (2014) The effects of weight-bearing conditions on patellofemoral indices in individuals without and with patellofemoral pain syndrome. Skeletal Radiol 43(2):157–164CrossRefPubMedGoogle Scholar
  17. 17.
    Laurin CA, Lévesque HP, Dussault R, Labelle H, Peides JP (1978) The abnormal lateral patellofemoral angle: a diagnostic roentgenographic sign of recurrent patellar subluxation. J Bone Joint Surg Am 60(1):55–60CrossRefPubMedGoogle Scholar
  18. 18.
    Lee CH, Ha CW, Kim S, Kim M, Song YJ (2013) A novel patellofemoral scoring system for patellofemoral joint status. J Bone Joint Surg Am 95(7):620–626CrossRefPubMedGoogle Scholar
  19. 19.
    Lee YS, Lee SB, Oh WS, Kwon YE, Lee BK (2016) Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 24(1):129–133CrossRefPubMedGoogle Scholar
  20. 20.
    Majima T, Yasuda K, Aoki Y, Minami A (2008) Impact of patellofemoral osteoarthritis on long-term outcome of high tibial osteotomy and effects of ventralization of tibial tubercle. J Orthop Sci 13(3):192–197CrossRefPubMedGoogle Scholar
  21. 21.
    Naal FD, Fischer M, Preuss A et al (2007) Return to sports and recreational activity after unicompartmental knee arthroplasty. Am J Sports Med 35(10):1688–1695CrossRefPubMedGoogle Scholar
  22. 22.
    Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B (1997) Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35–54 years with chronic knee pain. Ann Rheum Dis 56(8):493–496CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Song EK, Park JK, Park CH, Kim MC, Agrawal PR, Seon JK (2016) No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24(1):208–213CrossRefPubMedGoogle Scholar
  24. 24.
    Song IH, Song EK, Seo HY, Lee KB, Yim JH, Seon JK (2012) Patellofemoral alignment and anterior knee pain after closing- and opening-wedge valgus high tibial osteotomy. Arthroscopy 28(8):1087–1093CrossRefPubMedGoogle Scholar
  25. 25.
    Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neubauer H, Klinger HM (2013) The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 21(1):96–112CrossRefPubMedGoogle Scholar
  26. 26.
    Thompson SA, Liabaud B, Nellans KW, Geller JA (2013) Factors associated with poor outcomes following unicompartmental knee arthroplasty: redefining the “classic” indications for surgery. J Arthroplasty 28(9):1561–1564CrossRefPubMedGoogle Scholar
  27. 27.
    van Egmond N, van Grinsven S, van Loon CJ, Gaasbeek RD, van Kampen A (2016) Better clinical results after closed- compared to open-wedge high tibial osteotomy in patients with medial knee osteoarthritis and varus leg alignment. Knee Surg Sports Traumatol Arthrosc 24(1):34–41CrossRefPubMedGoogle Scholar
  28. 28.
    Yang JH, Lee SH, Nathawat KS, Jeon SH, Oh KJ (2013) The effect of biplane medial opening wedge high tibial osteotomy on patellofemoral joint indices. Knee 20(2):128–132CrossRefPubMedGoogle Scholar
  29. 29.
    Yim JH, Song EK, Seo HY, Kim MS, Seon JK (2013) Comparison of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthroplasty 28(2):243–247CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, IIsan Paik HospitalInje UniversityGoyangSouth Korea
  2. 2.Department of Orthopaedic SurgeryKonKuk University Medical Center, KonKuk University School of MedicneSeoulSouth Korea
  3. 3.Department of Orthopaedic SurgeryKS HospitalAnsanSouth Korea
  4. 4.Department of Orhopaedic SurgeryMullaji Knee ClinicMumbaiIndia

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