A meta-analysis of high tibial osteotomy and monocondylar replacement for treating medial interventricular osteoarthritis of the knee
10.3969/j.issn.2095-4344.2844
- Author:
Bai HAO
1
Author Information
1. Shanxi Medical University
- Publication Type:Journal Article
- Keywords:
High tibial osteotomy;
Knee;
Medial compartment;
Meta-analysis;
Monocondylar replacement;
Osteoarthritis
- From:
Chinese Journal of Tissue Engineering Research
2020;24(30):4905-4913
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: The most common surgical methods for the treatment of medial interventricular osteoarthritis of the knee are high tibial osteotomy and monocondylar replacement, and systematic evaluation of the difference in efficacy between the two is still lacking. OBJECTIVE: To compare the clinical efficacy of high tibial osteotomy and monocondylar replacement in the treatment of medial interventricular osteoarthritis of the knee. METHODS: PubMed, The Cochrane library, EMBASE, ScienceDirect, CNKI, Wanfang, and VIP were searched by computer. Literature was collected on observational cohort studies or randomized controlled trials comparing high tibial osteotomy/monocondylar replacement in the treatment of medial interventricular osteoarthritis of the knee, with a retrieval period from 2000 to 2019. Two people independently read and screened literature, extracted data and evaluated the quality of the study. RevMan 5.3 software was used for data analysis. RESULTS AND CONCLUSION: (1) A total of 13 studies were included, with 711 patients. (2) Meta-analysis results showed that the knee range of motion of high tibial osteotomy group (MD=-5.47, 95%CI: -9.53 to -1.41, P=0.008) was significantly better than that of monocondylar replacement group. Lysholm knee score (MD=0.84, 95%CI: 0.29 to 1.39, P=0.003) in the monocondylar replacement group at the last follow-up was significantly better than that of the high tibial osteotomy group. (3) There were no significant differences between the two groups in the incidence of postoperative complications, revision rate of total knee replacement, postoperative infection rate, degeneration rate of patellofemoral articular cartilage, degeneration rate of lateral compartment, excellent and good rate, and tibiofemoral angle after surgery (P > 0.05). (4) It is concluded that in the treatment of medial interventricular osteoarthritis of the knee according to the indications of operation, high tibial osteotomy can obtain similar complications, postoperative revision rate of total knee arthroplasty, postoperative infection, degeneration rate of patellofemoral articular cartilage, degeneration rate of the lateral compartment, excellent and good rate, postoperative tibial angle as monocondylar replacement, but the postoperative motion range of high tibial osteotomy is better than that of monocondylar replacement, while monocondylar replacement enables better knee function.
