Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 28:20:101107.
doi: 10.1016/j.artd.2023.101107. eCollection 2023 Apr.

Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures

Philip A Serbin  1 , Dang-Huy Do  1 , Andrew Hinkle  1 , Dane Wukich  1 , Michael Huo  1 , Senthil Sambandam  1
Affiliations

Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures

Philip A Serbin et al. Arthroplast Today. .

Abstract

Background: There is no consensus on whether unicompartmental arthroplasty (UKA) or high tibial osteotomy (HTO) is superior for unicompartmental arthritis. While there are studies comparing revision and complication rates, none matched a large number of patients undergoing HTO and UKA in the United States and compared these outcomes. We investigated TKA conversion rate and the complications following HTO or UKA.

Methods: This retrospective study queried the PearlDiver database of all patients undergoing UKA and HTO using CPT codes between January 2011 and January 2020. We compared propensity-matched populations based on age, gender, Charlson comorbidity index, and Elixhauser comorbidity index to compare odds of complications, TKA conversion, and drug use between UKA and HTO groups. Two-independent sample t-test for unequal variances and test of significance were performed.

Results: We found 32,583 UKA patients and 816 HTO patients. Each matched group had 535 patients. One-year complication showed higher risk of pneumonia, hematoma, infection, and mechanical complications among HTO patients. UKA patients used narcotics on average of 10.3 days compared to 9.1 days among HTO patients (P < .01). UKA conversion rates were 4.1%, 5.4%, 7.7%, and 9.2% at 1-, 2-, 5-, and 10-year intervals, respectively. HTO conversion rates were less than 2% at 1- and 2-year intervals, 3.4% at 5-year, and 4.5% at 10-year intervals. This difference was statistically significant at 5- and 10-year intervals (P < .01).

Conclusions: Using large matched cohorts, HTO may be converted to TKA later than UKA in short- to mid-term follow-up, and HTO patients used opioids for shorter duration.

Keywords: Conversion; High tibial osteotomy; Opioids; Outcomes; Total knee arthroplasty; Unicompartmental arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Rates of conversion to TKA in matched cohorts of UKA vs HTO at designated time intervals. Note: not enough data for HTO at 1- and 2-year intervals.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Brophy R.H., Fillingham Y.A. AAOS clinical practice guideline summary: management of osteoarthritis of the knee (nonarthroplasty), third edition. J Am Acad Orthop Surg. 2022;30:e721–e729. doi: 10.5435/JAAOS-D-21-01233. - DOI - PubMed
    1. Stoddart J.C., Dandridge O., Garner A., Cobb J., van Arkel R.J. The compartmental distribution of knee osteoarthritis - a systematic review and meta-analysis. Osteoarthritis Cartilage. 2021;29:445–455. doi: 10.1016/j.joca.2020.10.011. - DOI - PubMed
    1. Ivarsson I., Gillquist J. Rehabilitation after high tibial osteotomy and unicompartmental arthroplasty. A comparative study. Clin Orthop Relat Res. 1991;266:139–144. - PubMed
    1. Cao Z., Mai X., Wang J., Feng E., Huang Y. Unicompartmental knee arthroplasty vs high tibial osteotomy for knee osteoarthritis: a systematic review and meta-analysis. J Arthroplasty. 2018;33:952–959. doi: 10.1016/j.arth.2017.10.025. - DOI - PubMed
    1. Jackson J.P., Waugh W. Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br. 1961;43-B:746–751. doi: 10.1302/0301-620X.43B4.746. - DOI - PubMed

LinkOut - more resources