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Upper Tibial Osteotomy or Unicompartmental Knee Arthroplasty for Medial Compartment Knee Osteoarthritis: Evidence-Based Indications for Treatment

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Controversies in Orthopaedic Surgery of the Lower Limb

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Abstract

Available treatments for medial compartment osteoarthritis (OA) of the knee can include non-surgical and surgical options. Currently accepted surgical treatments aim to either preserve the joint surfaces whilst addressing malalignment of the limb (osteotomy) or replace the joint itself (arthroplasty). Where total knee arthroplasty (TKA) has historically been a popular choice in these patients, unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) have evolved to provide favourable outcomes in selected patients. There has been much debate as to which procedure is preferable in these circumstances, suggesting a significant overlap in reported indications. In this chapter we describe the historical origins of both HTO and UKA, exploring how changing indications reflect improvements in surgical techniques combined with a better understanding of the natural history of OA. HTO and UKA both provide excellent results in the treatment of medial compartment knee OA. Patients who experience reliably good outcomes in either group are clinically and radiographically distinct from each other. It is therefore likely that the group of patients in whom HTO and UKA are equally indicated is much smaller than has been previously suggested.

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Authors and Affiliations

  1. Nuffield Orthopaedic Centre, Oxford, UK

    Alexander D. Shearman, Nicholas J. Bottomley, William F. M. Jackson & Andrew J. Price

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital Universitario La Paz, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. Department of Orthopaedic Surgery, Imperial College London, London, UK

    Alexander D. Liddle

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Shearman, A.D., Bottomley, N.J., Jackson, W.F.M., Price, A.J. (2021). Upper Tibial Osteotomy or Unicompartmental Knee Arthroplasty for Medial Compartment Knee Osteoarthritis: Evidence-Based Indications for Treatment. In: Rodríguez-Merchán, E.C., Liddle, A.D. (eds) Controversies in Orthopaedic Surgery of the Lower Limb. Springer, Cham. https://doi.org/10.1007/978-3-030-80695-8_10

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  • DOI: https://doi.org/10.1007/978-3-030-80695-8_10

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