Facteurs prédictifs de satisfaction du patient après prothèse unicompartimentaire et ostéotomie tibiale dans l’arthrose fémorale tibiale médiale du genou - 28/01/19
Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis
Abstract |
Introduction |
Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are viable treatment options for early osteoarthritis (OA). Although a substantial proportion of the patient selection criteria for HTO and UKA are now shared, the factors related to satisfaction following each procedure remain unclear.
Hypothesis |
We hypothesized that patient factors associated with satisfaction following contemporary HTO and UKA would be different.
Material and Methods |
We retrospectively reviewed the records of consecutively enrolled medial opening-wedge HTOs (n=123) and Oxford mobile bearing UKAs (n=118) with satisfactory postoperative alignment. Preoperative demographics, physical activity levels, varus deformity status, and degree of OA were recorded. Postoperative radiographs, frequency of combined procedures and patient-reported outcomes (PROs) including pain, Western Ontario and McMaster Universities Osteoarthritis Index score, and patient satisfaction were assessed.
Results |
Severe OA (p<0.01) was associated with an increased risk of dissatisfaction following HTO, whereas young age (p<0.01) and severe varus deformity (p=0.045) were related to dissatisfaction after UKA. In addition, patient satisfaction following UKA was higher than that following HTO in individuals with highly physically demanding activity. All UKA PROs were superior to those of the HTO group, except pain level.
Conclusion |
Despite the shared patient selection criteria for contemporary HTO and UKA, severe OA was associated with dissatisfaction following HTO, whereas young age and varus deformity were associated with dissatisfaction following UKA. Age, varus deformity and OA severity should be considered when deciding whether to perform HTO or UKA.
Type of study and level of proof |
Retrospective cohort study, Level III.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Patient selection, Patient-reported outcomes, Early knee osteoarthritis, High tibial osteotomy, Unicompartmental knee arthroplasty
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 105 - N° 1
P. 40 - Febbraio 2019 Ritorno al numero
Articolo precedente
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- Kang-Il Kim, Dong-Kyoon Kim, Sang-Jun Song, Se-Jung Hong, Dae-Kyung Bae
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- Gareth G. Jones, Susannah Clarke, Martin Jaere, Justin P. Cobb
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