Comparative analysis of the results obtained after unicondylar knee arthroplasty and high tibial osteotomy in isolated gonarthrosis

Abstract

The AIM of this study was to analyse the results of the surgery and compare the outcomes of unicondylar knee arthroplasty and high tibial osteotomy performed in isolated gonarthrosis.

Patients and methods: Between 2007 and 2011, 65 patients were implanted a partial knee endo-prosthesis in the Clinic of Orthopedics and Traumatology. Men were 23 (35.4%) and women were 42 (64.6%). High tibial osteotomy was performed to manage the unicompartmental gonarthrosis in 92 patients (47 men and 45 women) for 13 years between 1975 and 1987. These two modalities were used only in cases in which one of the knee joint compartments was affected. Clinical, para-clinical, functional tests and radiographic examination were conducted of the affected knee joint.

Results: The results of the study were assessed by the rating system proposed by the Knee Society and modified by John Insall. At four-year follow-up study the outcomes of the partial prosthesis were assessed as excellent in 85.13%, good--in 13.11% and satisfactory in 1.77% of patients. After high tibial osteotomy the results were considered very good in 54.18% of patients, good--in 32.29%, satisfactory--in 6.25%, and poor--in 7.8%.

Conclusions: Partial knee arthroplasty is a resurfacing procedure, while high tibial osteotomy is used only to slow the overall degenerative process with gradual progressive exacerbation of osteoarthritis with age. The results after prosthetic treatment had a better dynamics than that in high tibial osteotomy.