This systematic review and pooling data analysis provides a comprehensive examination of how medial opening wedge high tibial osteotomy (HTO) and medial unicompartmental knee arthroplasty (UKA) impact a patient’s physical activity levels after surgery. By synthesising and analysing data from a significant body of research, the study offers valuable insights into the recovery outcomes of these two prominent procedures for treating knee osteoarthritis.
Key Findings on Physical Activity and Function
The research analysed data from a total of 13 studies, encompassing 401 knees treated with HTO and 1,622 with UKA. A key finding was that patients in the HTO group were typically more active than UKA patients, both before and after their respective surgical procedures. This suggests that HTO is more frequently performed on a younger, more active patient population, as it is often considered a procedure for the “young active patient” who is under 50 years of age. In contrast, UKA is more often indicated for patients who are over 60 with a lower activity demand.
However, the study revealed a significant finding regarding postoperative improvement: UKA patients experienced a more substantial overall increase in both physical activity and knee function compared to their HTO counterparts. These improvements were measured by the validated Tegner and Lysholm scores, which are common tools used to assess patient-reported outcomes after knee surgery. The Lysholm Knee Score assesses knee instability and function across several domains, with higher scores indicating better function, while the Tegner Activity Scale is a numerical scale used to grade activity levels. While HTO is comparable to UKA in terms of clinical outcomes, the data from this review suggests that UKA provides a greater boost to a patient’s physical abilities and functional scores post-surgery.
Influencing Factors and Clinical Considerations The review suggests that various operative factors can influence postoperative physical activity levels. For example, implant selection and the use of graft materials during HTO may play a role, although the research notes that further investigation is needed in this area. The study also highlights that a patient’s age and body mass index (BMI), which are traditionally considered relative contraindications for both
HTO and UKA, do not necessarily prevent a successful return to physical activity after surgery. This is a crucial finding, as it challenges conventional patient selection criteria and offers a more nuanced perspective on who may benefit from these procedures.
In essence, the findings indicate that while HTO patients may start at a higher baseline activity level, UKA patients stand to gain a more significant improvement in function, making it an effective choice for those seeking to enhance their postoperative lifestyle. The review confirms that, with correct patient selection, both procedures can be effective and reliable.
For a complete analysis of the full data and methodology, the complete research paper is available at:
Sources used in report overview:
- https://pubmed.ncbi.nlm.nih.gov/32960075/
- https://www.physiotutors.com/questionnaires/tegner-lysholm-knee-score/
- https://pubmed.ncbi.nlm.nih.gov/19307332/
- http://www.jksrr.org/journal/view.html?doi=10.5792/ksrr.17.006
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8758909/
- https://www.researchgate.net/publication/257206666_Unicompartmental_knee_replacement_after_high_tibial_osteotomy_Invalidating_a_contraindication
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5100444/
