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Gonartroz tedavisinde hareketli unikompartmantal diz artroplastisi, açık kama ve dome tipi yüksek tibial osteotomi seçeneklerinin değerlendirilmesi

Year 2015, Volume: 49 Issue: 3, 280 - 287, 17.07.2015
https://doi.org/10.3944/AOTT.2015.14.0320

Abstract

Amaç: Gonartroz tedavisinde uygulanan hareketli unikompartmantal diz artroplastisi, açık kama ve dome tipi yüksek tibial osteotomi yöntemleri hasta memnuniyeti, yaşam kalitesi ve fonksiyonel sonuçlar açısından retrospektif olarak karşılaştırmayı amaçladık.

Çalışma planı: 2003-2010 yılları arasında 235 hastanın 255 dizi medial kompartman artrozu nedeniyle ameliyat edildi. Unikompartmantal diz artroplastisi (UDP), kilitli plakla açık kama yüksek tibial osteotomi (YTO) ve sirküler eksternal fiksatörle kubbe tipi YTO olmak üzere üç tip cerrahi tedavi gerçekleştirildi. İlk grupta 94 hastanın 109 dizine Oxford UDP uygulandı. İkinci grupta 36 hastanın 36 dizine İlizarovla kubbe tipi YTO yapıldı. Üçüncü grupta ise 52 hastanın 57 dizine kilitli plakla açık kama YTO yapıldı. Grupların fonksiyonel skorlarının karşılaştırılmasında SF-36 ve HSS diz skorları kullanıldı.

Bulgular: Her üç tedavi grubunda da ameliyat öncesi ve ameliyat sonrası değerler karşılaştırıldığında SF-36’nın tüm alt parametreleri (fiziksel fonksiyon, fiziksel rol, ağrı, genel sağlık, vitalite, sosyal fonksiyon, emosyonel rol ve mental sağlık) ve HSS skorlarında anlamlı değişiklikler saptandı. İkinci grupta mekanik aks sapmasında ortalama 38 mm, femoro-tibial aksta ortalama 11.7° ve medial proksimal tibial açıda ortalama 6.2° düzeltme elde edildi. Üçüncü grupta ise; mekanik aks sapmasında ortalama 28 mm, femoro-tibial aksta ortalama 9.7° ve medial proksimal tibial açıda ortalama 5.6° düzeltme elde edildi. Tüm tedavi seçeneklerinin tatmin edici sonuçlarının olduğu görüldü.

Çıkarımlar: UDP grubunda sosyal fonksiyon ve mental sağlık açısından ameliyat sonrası iyi sonuçlar elde edilmiş ve hastaların rehabilitasyonu ve önceki yaşam aktivitelerine geri dönmeleri daha erken sağlanmıştır.

 

DOI: 10.3944/AOTT.2015.14.0320

Bu özet, makalenin henüz redaksiyonu tamamlanmamış haline aittir ve bilgi verme amaçlıdır. Yayın aşamasında değişiklik gösterebilir.

References

  • Insall J, Aglietti P. A five to seven-year follow-up of unicon- dylar arthroplasty. J Bone Joint Surg Am 1980;62:1329– 37.
  • Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am 1978;60:182–5.
  • Palmer SH, Morrison PJ, Ross AC. Early catastrophic tibial component wear after unicompartmental knee ar- throplasty. Clin Orthop Relat Res 1998;350:143–8.
  • Whittaker JP, Naudie DD, McAuley JP, McCalden RW, MacDonald SJ, Bourne RB. Does bearing design influence midterm survivorship of unicompartmental arthroplasty? Clin Orthop Relat Res 2010;468:73–81.
  • Emerson RH Jr, Higgins LL. Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 2008;90:118–22.
  • O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, et al. The John Insall Award: unicom- partmental knee replacement: a minimum twenty-one- year followup, end-result study. Clin Orthop Relat Res 2005;440:27–37.
  • Price AJ, Short A, Kellett C, Beard D, Gill H, Pandit H, et al. Ten-year in vivo wear measurement of a fully congru- ent mobile bearing unicompartmental knee arthroplasty. J Bone Joint Surg Br 2005;87:1493–7.
  • Tabor OB Jr, Tabor OB. Unicompartmental arthroplasty: a long-term follow-up study. J Arthroplasty 1998;13:373– 9.
  • Zermatten P, Munzinger U. The Oxford II medial uni- compartmental knee arthroplasty: an independent 10- year survival study. Acta Orthop Belg 2012;78:203–9.
  • Akizuki S, Mueller JK, Horiuchi H, Matsunaga D, Shibakawa A, Komistek RD. In vivo determination of ki- nematics for subjects having a Zimmer Unicompartmental High Flex Knee System. J Arthroplasty 2009;24:963–71.
  • Bonutti PM, Mont MA, McMahon M, Ragland PS, Kes- ter M. Minimally invasive total knee arthroplasty. J Bone Joint Surg Am 2004;86-A Suppl 2:26–32.
  • Gesell MW, Tria AJ Jr. MIS unicondylar knee arthroplas- ty: surgical approach and early results. Clin Orthop Relat Res 2004;428:53–60.
  • Dowd GS, Somayaji HS, Uthukuri M. High tibial os- teotomy for medial compartment osteoarthritis. Knee 2006;13:87–92.
  • Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R. High tibial osteotomy versus unicompart- mental knee arthroplasty for medial compartment arthro- sis of the knee: a review of the literature. Iowa Orthop J 2010;30:131–40.
  • Lombardi AV Jr, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA. Is recovery faster for mobile-bearing uni- compartmental than total knee arthroplasty? Clin Orthop Relat Res 2009;467:1450–7.
  • Weidenhielm L, Olsson E, Broström LA, Börjesson- Hederström M, Mattsson E. Improvement in gait one year after surgery for knee osteoarthrosis: a comparison between high tibial osteotomy and prosthetic replacement in a prospective randomized study. Scand J Rehabil Med 1993;25:25–31.
  • Weale AE, Halabi OA, Jones PW, White SH. Perceptions of outcomes after unicompartmental and total knee re- placements. Clin Orthop Relat Res 2001;382:143–53.
  • Maly MR, Costigan PA, Olney SJ. Determinants of self- report outcome measures in people with knee osteoarthri- tis. Arch Phys Med Rehabil 2006;87:96–104.
  • Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am 2003;85- A:1968–73.
  • Schai PA, Suh JT, Thornhill TS, Scott RD. Unicompart- mental knee arthroplasty in middle-aged patients: a 2- to 6-year follow-up evaluation. J Arthroplasty 1998;13:365– 72.
  • Ryd L, Kärrholm J, Ahlvin P. Knee scoring systems in gon- arthrosis. Evaluation of interobserver variability and the envelope of bias. Score Assessment Group. Acta Orthop Scand 1997;68:41–5.
  • Murray DW, Goodfellow JW, O’Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998;80:983–9.
  • Price AJ, Waite JC, Svard U. Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 2005;435:171–80.
  • Rajasekhar C, Das S, Smith A. Unicompartmental knee arthroplasty. 2- to 12-year results in a community hospital. J Bone Joint Surg Br 2004;86:983–5.
  • Flecher X, Parratte S, Aubaniac JM, Argenson JN. A 12- 28-year followup study of closing wedge high tibial oste- otomy. Clin Orthop Relat Res 2006;452:91–6.
  • Stuart MJ, Grace JN, Ilstrup DM, Kelly CM, Adams RA, Morrey BF. Late recurrence of varus deformity af- ter proximal tibial osteotomy. Clin Orthop Relat Res 1990;260:61–5.
  • Virolainen P, Aro HT. High tibial osteotomy for the treat- ment of osteoarthritis of the knee: a review of the litera- ture and a meta-analysis of follow-up studies. Arch Or- thop Trauma Surg 2004;124:258–61.
  • Odenbring S, Egund N, Knutson K, Lindstrand A, Larsen ST. Revision after osteotomy for gonarthrosis. A 10-19-year follow-up of 314 cases. Acta Orthop Scand 1990;61:128–30.
  • Coventry MB, Ilstrup DM, Wallrichs SL. Proximal tibial osteotomy. A critical long-term study of eighty-seven cas- es. J Bone Joint Surg Am 1993;75:196–201.
  • Huang TL, Tseng KF, Chen WM, Lin RM, Wu JJ, Chen TH. Preoperative tibiofemoral angle predicts sur- vival of proximal tibia osteotomy. Clin Orthop Relat Res 2005;432:188–95.
  • Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The Install Award. Survivorship of the high tibial valgus os- teotomy. A 10- to -22-year followup study. Clin Orthop Relat Res 1999;367:18–27.
  • Insall J, Walker P. Unicondylar knee replacement. Clin Or- thop Relat Res 1976;120:83–5.
  • W-Dahl A, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S. Unicompartmental knee arthroplasty in pa- tients aged less than 65. Acta Orthop 2010;81:90–4.
  • Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neu- bauer H, Klinger HM. The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013;21:96–112.
  • Yim JH, Song EK, Seo HY, Kim MS, Seon JK. Compari- son of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthro- plasty 2013;28:243–7.
  • Takeuchi R, Umemoto Y, Aratake M, Bito H, Saito I, Kumagai K, et al. A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthro- plasty for medial compartment osteoarthritis of the knee. J Orthop Surg Res 2010;5:65.

Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis

Year 2015, Volume: 49 Issue: 3, 280 - 287, 17.07.2015
https://doi.org/10.3944/AOTT.2015.14.0320

Abstract

Objective: Three methods of surgery used in the treatment of knee osteoarthritis (OA) are mobile bearing unicompartmental knee arthroplasty (Oxford UKA), opening wedge high tibial osteotomy (HTO), and dome-type HTO. This article aimed to retrospectively compare these three methods in terms of outcomes for health status, patient satisfaction, and function.
Methods: Between 2003 and 2010, 255 knees of 235 patients underwent operations for medial knee OA. Three types of surgery were performed. Group 1 consisted of 109 knees of 94 patients who underwent Oxford UKA. Group 2 was made up of 36 knees of 36 patients who underwent HTO using circular external fixation, and Group 3 comprised 57 knees of 52 patients on whom opening wedge type HTO using locking plate fixation was performed. SF-36 and HSS knee scores were used to compare the functional outcomes among groups.
Results: Statistically significant differences were found between the preoperative and postoperative measures in all 3 of the treatment groups for physical function, physical role, pain, general health, vitality, social function, emotional role, and mental health according to SF-36 and HSS scores. In the 2nd group, the average correction of the mechanical axis deviation (MAD) was 38 mm with 11.7º along the femorotibial axis and 6.2º along the medial proximal tibial angle (MPTA). In the 3rd group, the average correction in the MAD was 28 mm with 9.7º along the femorotibial axis and 5.6º along the MPTA. All 3 of the treatment alternatives were observed to be sufficient. Satisfactory postoperative results were achieved in the UKA group in terms of social function and mental health, and the patients were able to achieve early rehabilitation and return to their previous life activities.
Conclusion: UKA is the ideal option for patients who wish for the earliest possible return to social and recreational activities.

References

  • Insall J, Aglietti P. A five to seven-year follow-up of unicon- dylar arthroplasty. J Bone Joint Surg Am 1980;62:1329– 37.
  • Laskin RS. Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Joint Surg Am 1978;60:182–5.
  • Palmer SH, Morrison PJ, Ross AC. Early catastrophic tibial component wear after unicompartmental knee ar- throplasty. Clin Orthop Relat Res 1998;350:143–8.
  • Whittaker JP, Naudie DD, McAuley JP, McCalden RW, MacDonald SJ, Bourne RB. Does bearing design influence midterm survivorship of unicompartmental arthroplasty? Clin Orthop Relat Res 2010;468:73–81.
  • Emerson RH Jr, Higgins LL. Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg Am 2008;90:118–22.
  • O’Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, et al. The John Insall Award: unicom- partmental knee replacement: a minimum twenty-one- year followup, end-result study. Clin Orthop Relat Res 2005;440:27–37.
  • Price AJ, Short A, Kellett C, Beard D, Gill H, Pandit H, et al. Ten-year in vivo wear measurement of a fully congru- ent mobile bearing unicompartmental knee arthroplasty. J Bone Joint Surg Br 2005;87:1493–7.
  • Tabor OB Jr, Tabor OB. Unicompartmental arthroplasty: a long-term follow-up study. J Arthroplasty 1998;13:373– 9.
  • Zermatten P, Munzinger U. The Oxford II medial uni- compartmental knee arthroplasty: an independent 10- year survival study. Acta Orthop Belg 2012;78:203–9.
  • Akizuki S, Mueller JK, Horiuchi H, Matsunaga D, Shibakawa A, Komistek RD. In vivo determination of ki- nematics for subjects having a Zimmer Unicompartmental High Flex Knee System. J Arthroplasty 2009;24:963–71.
  • Bonutti PM, Mont MA, McMahon M, Ragland PS, Kes- ter M. Minimally invasive total knee arthroplasty. J Bone Joint Surg Am 2004;86-A Suppl 2:26–32.
  • Gesell MW, Tria AJ Jr. MIS unicondylar knee arthroplas- ty: surgical approach and early results. Clin Orthop Relat Res 2004;428:53–60.
  • Dowd GS, Somayaji HS, Uthukuri M. High tibial os- teotomy for medial compartment osteoarthritis. Knee 2006;13:87–92.
  • Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R. High tibial osteotomy versus unicompart- mental knee arthroplasty for medial compartment arthro- sis of the knee: a review of the literature. Iowa Orthop J 2010;30:131–40.
  • Lombardi AV Jr, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA. Is recovery faster for mobile-bearing uni- compartmental than total knee arthroplasty? Clin Orthop Relat Res 2009;467:1450–7.
  • Weidenhielm L, Olsson E, Broström LA, Börjesson- Hederström M, Mattsson E. Improvement in gait one year after surgery for knee osteoarthrosis: a comparison between high tibial osteotomy and prosthetic replacement in a prospective randomized study. Scand J Rehabil Med 1993;25:25–31.
  • Weale AE, Halabi OA, Jones PW, White SH. Perceptions of outcomes after unicompartmental and total knee re- placements. Clin Orthop Relat Res 2001;382:143–53.
  • Maly MR, Costigan PA, Olney SJ. Determinants of self- report outcome measures in people with knee osteoarthri- tis. Arch Phys Med Rehabil 2006;87:96–104.
  • Pennington DW, Swienckowski JJ, Lutes WB, Drake GN. Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg Am 2003;85- A:1968–73.
  • Schai PA, Suh JT, Thornhill TS, Scott RD. Unicompart- mental knee arthroplasty in middle-aged patients: a 2- to 6-year follow-up evaluation. J Arthroplasty 1998;13:365– 72.
  • Ryd L, Kärrholm J, Ahlvin P. Knee scoring systems in gon- arthrosis. Evaluation of interobserver variability and the envelope of bias. Score Assessment Group. Acta Orthop Scand 1997;68:41–5.
  • Murray DW, Goodfellow JW, O’Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998;80:983–9.
  • Price AJ, Waite JC, Svard U. Long-term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 2005;435:171–80.
  • Rajasekhar C, Das S, Smith A. Unicompartmental knee arthroplasty. 2- to 12-year results in a community hospital. J Bone Joint Surg Br 2004;86:983–5.
  • Flecher X, Parratte S, Aubaniac JM, Argenson JN. A 12- 28-year followup study of closing wedge high tibial oste- otomy. Clin Orthop Relat Res 2006;452:91–6.
  • Stuart MJ, Grace JN, Ilstrup DM, Kelly CM, Adams RA, Morrey BF. Late recurrence of varus deformity af- ter proximal tibial osteotomy. Clin Orthop Relat Res 1990;260:61–5.
  • Virolainen P, Aro HT. High tibial osteotomy for the treat- ment of osteoarthritis of the knee: a review of the litera- ture and a meta-analysis of follow-up studies. Arch Or- thop Trauma Surg 2004;124:258–61.
  • Odenbring S, Egund N, Knutson K, Lindstrand A, Larsen ST. Revision after osteotomy for gonarthrosis. A 10-19-year follow-up of 314 cases. Acta Orthop Scand 1990;61:128–30.
  • Coventry MB, Ilstrup DM, Wallrichs SL. Proximal tibial osteotomy. A critical long-term study of eighty-seven cas- es. J Bone Joint Surg Am 1993;75:196–201.
  • Huang TL, Tseng KF, Chen WM, Lin RM, Wu JJ, Chen TH. Preoperative tibiofemoral angle predicts sur- vival of proximal tibia osteotomy. Clin Orthop Relat Res 2005;432:188–95.
  • Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The Install Award. Survivorship of the high tibial valgus os- teotomy. A 10- to -22-year followup study. Clin Orthop Relat Res 1999;367:18–27.
  • Insall J, Walker P. Unicondylar knee replacement. Clin Or- thop Relat Res 1976;120:83–5.
  • W-Dahl A, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S. Unicompartmental knee arthroplasty in pa- tients aged less than 65. Acta Orthop 2010;81:90–4.
  • Spahn G, Hofmann GO, von Engelhardt LV, Li M, Neu- bauer H, Klinger HM. The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013;21:96–112.
  • Yim JH, Song EK, Seo HY, Kim MS, Seon JK. Compari- son of high tibial osteotomy and unicompartmental knee arthroplasty at a minimum follow-up of 3 years. J Arthro- plasty 2013;28:243–7.
  • Takeuchi R, Umemoto Y, Aratake M, Bito H, Saito I, Kumagai K, et al. A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthro- plasty for medial compartment osteoarthritis of the knee. J Orthop Surg Res 2010;5:65.
There are 36 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

İbrahim Tuncay

Kerem Bilsel

Mehmet Elmadag This is me

Omer Erkocak This is me

Murat Asci This is me

Cengiz Sen

Publication Date July 17, 2015
Published in Issue Year 2015 Volume: 49 Issue: 3

Cite

APA Tuncay, İ., Bilsel, K., Elmadag, M., Erkocak, O., et al. (2015). Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthopaedica Et Traumatologica Turcica, 49(3), 280-287. https://doi.org/10.3944/AOTT.2015.14.0320
AMA Tuncay İ, Bilsel K, Elmadag M, Erkocak O, Asci M, Sen C. Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthopaedica et Traumatologica Turcica. July 2015;49(3):280-287. doi:10.3944/AOTT.2015.14.0320
Chicago Tuncay, İbrahim, Kerem Bilsel, Mehmet Elmadag, Omer Erkocak, Murat Asci, and Cengiz Sen. “Evaluation of Mobile Bearing Unicompartmental Knee Arthroplasty, Opening Wedge, and Dome-Type High Tibial Osteotomies for Knee Arthritis”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 3 (July 2015): 280-87. https://doi.org/10.3944/AOTT.2015.14.0320.
EndNote Tuncay İ, Bilsel K, Elmadag M, Erkocak O, Asci M, Sen C (July 1, 2015) Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthopaedica et Traumatologica Turcica 49 3 280–287.
IEEE İ. Tuncay, K. Bilsel, M. Elmadag, O. Erkocak, M. Asci, and C. Sen, “Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 3, pp. 280–287, 2015, doi: 10.3944/AOTT.2015.14.0320.
ISNAD Tuncay, İbrahim et al. “Evaluation of Mobile Bearing Unicompartmental Knee Arthroplasty, Opening Wedge, and Dome-Type High Tibial Osteotomies for Knee Arthritis”. Acta Orthopaedica et Traumatologica Turcica 49/3 (July 2015), 280-287. https://doi.org/10.3944/AOTT.2015.14.0320.
JAMA Tuncay İ, Bilsel K, Elmadag M, Erkocak O, Asci M, Sen C. Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthopaedica et Traumatologica Turcica. 2015;49:280–287.
MLA Tuncay, İbrahim et al. “Evaluation of Mobile Bearing Unicompartmental Knee Arthroplasty, Opening Wedge, and Dome-Type High Tibial Osteotomies for Knee Arthritis”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 3, 2015, pp. 280-7, doi:10.3944/AOTT.2015.14.0320.
Vancouver Tuncay İ, Bilsel K, Elmadag M, Erkocak O, Asci M, Sen C. Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis. Acta Orthopaedica et Traumatologica Turcica. 2015;49(3):280-7.