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DOI: 10.1055/a-2712-4186
Comparison of Functional Outcomes of High Tibial Osteotomy and Unicompartmental Knee Arthroplasty in Patients with Medial Knee Osteoarthritis
Authors

Abstract
Unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) surgeries are often preferred in individuals with medial knee osteoarthritis (OA). The aim of the study was to compare the functional outcomes of patients with UKA and HTO. Seventy-seven individuals were included in the study, of which 39 individuals had undergone HTO surgery (median age = 58.38 ± 7.99, median body mass index [BMI] = 30.93 ± 3.33 kg/m2) and 38 individuals had undergone UKA surgery (median age = 62.95 ± 7.74 years, median BMI = 30.48 ± 3.57 kg/m2). Pain was evaluated before and after surgery. Pain severity, 6-Minute Walk Test (6MWT), 10-Repetition Sitto-Stand Test (10 × STS), stairs test, Timed Up and Go (TUG), and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire were used for functional evaluation. There were no differences in demographic characteristics between groups (p > 0.05). The HTO group had lower postoperative pain (p = 0.043) and KOOS pain subscale scores (p = 0.043), better stairs test (p = 0.041), and 10 × STS results (p = 0.007). There were no significant differences between the groups in terms of the 6MWT, TUG, and KOOS total scores (p > 0.05). The results showed that individuals who underwent HTO surgery experienced less postoperative pain and had better functional levels compared with those who underwent UKA surgery. It shows that good functional performance can be achieved with HTO surgery in early medial compartment OA.
Keywords
knee osteoarthritis - high tibial osteotomy - unicompartmental knee arthroplasty - functional performanceEthical Approval
Clinical research ethics board of Atlas University, date: December 23, 2024, no: 10/47.
Publikationsverlauf
Eingereicht: 02. Juli 2025
Angenommen: 26. September 2025
Artikel online veröffentlicht:
14. Oktober 2025
© 2025. Thieme. All rights reserved.
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References
- 1 Beydağı MG, Bazancir Z, Bozgeyik S. et al. Is therapeutic exercise clinically effective in reducing pain intensity in patients with knee osteoarthritis? A systematic review. Top Geriatr Rehabil 2021; 37 (02) 89-103
- 2 Bozgeyik S, Kinikli GI, Topal Y. et al. Supervised exercises have superior effects compared to home-based exercises for patients with knee osteoarthritis following platelet-rich plasma injection. Res Sports Med 2024; 32 (02) 279-289
- 3 Alvand A, Khan T, Jenkins C. et al. The impact of patient-specific instrumentation on unicompartmental knee arthroplasty: a prospective randomised controlled study. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1662-1670
- 4 Gomoll AH. High tibial osteotomy for the treatment of unicompartmental knee osteoarthritis: a review of the literature, indications, and technique. Phys Sportsmed 2011; 39 (03) 45-54
- 5 Dettoni F, Bonasia DE, Castoldi F, Bruzzone M, Blonna D, Rossi R. High tibial osteotomy versus unicompartmental knee arthroplasty for medial compartment arthrosis of the knee: a review of the literature. Iowa Orthop J 2010; 30: 131-140
- 6 Amendola A, Panarella L. High tibial osteotomy for the treatment of unicompartmental arthritis of the knee. Orthop Clin North Am 2005; 36 (04) 497-504
- 7 Jamali AA, Scott RD, Rubash HE, Freiberg AA. Unicompartmental knee arthroplasty: past, present, and future. Am J Orthop 2009; 38 (01) 17-23
- 8 Fu D, Li G, Chen K, Zhao Y, Hua Y, Cai Z. Comparison of high tibial osteotomy and unicompartmental knee arthroplasty in the treatment of unicompartmental osteoarthritis: a meta-analysis. J Arthroplasty 2013; 28 (05) 759-765
- 9 Hui C, Salmon LJ, Kok A. et al. Long-term survival of high tibial osteotomy for medial compartment osteoarthritis of the knee. Am J Sports Med 2011; 39 (01) 64-70
- 10 Pandit H, Gulati A, Jenkins C. et al. Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment. Knee 2011; 18 (03) 168-171
- 11 Han SB, Kyung HS, Seo IW, Shin YS. Better clinical outcomes after unicompartmental knee arthroplasty when comparing with high tibial osteotomy. Medicine (Baltimore) 2017; 96 (50) e9268
- 12 Xie T, de Vries AJ, van der Veen HC, Brouwer RW. Total knee arthroplasty following lateral closing-wedge high tibial osteotomy versus primary total knee arthroplasty: a propensity score matching study. J Orthop Surg Res 2024; 19 (01) 283
- 13 Arnold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr 2007; 7: 17
- 14 Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord 2013; 14: 145
- 15 Dobson F, Hinman RS, Roos EM. et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21 (08) 1042-1052
- 16 Bennell K, Dobson F, Hinman R. Measures of physical performance assessments: self-paced walk test (SPWT), stair climb test (SCT), six-minute walk test (6MWT), chair stand test (CST), timed up & go (TUG), sock test, lift and carry test (LCT), and car task. Arthritis Care Res (Hoboken) 2011; 63 (Suppl. 11) S350-S370
- 17 Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord 2005; 6: 3
- 18 Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. Phys Ther 2005; 85 (10) 1034-1045
- 19 Bouguennec N, Mergenthaler G, Gicquel T. et al; Francophone Arthroscopy Society. Medium-term survival and clinical and radiological results in high tibial osteotomy: factors for failure and comparison with unicompartmental arthroplasty. Orthop Traumatol Surg Res 2020; 106 (8S): S223-S230
- 20 Debopadhaya S, Acosta E, Ortiz III D. Trends and outcomes in the surgical management of young adults with knee osteoarthritis using high tibial osteotomy and unicompartmental knee arthroplasty. Arch Orthop Trauma Surg 2024; 144 (09) 3995-4002
- 21 Zhang B, Qian H, Wu H, Yang X. Unicompartmental knee arthroplasty versus high tibial osteotomy for medial knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg (Hong Kong) 2023;31(1):10225536231162829
- 22 Nazlıgül AS, Gürler A, Tecimel O, Yılmaz S, Doğan M, Akkaya M. The effect of high tibial osteotomy and unicompartmental knee arthroplasty on patellofemoral joint in young patients with medial knee arthrosis. Arch Orthop Trauma Surg 2024; 144 (09) 3989-3994
- 23 Ping H, Wen J, Liu Y. et al. Unicompartmental knee arthroplasty is associated with lower pain levels but inferior range of motion, compared with high tibial osteotomy: a systematic overview of meta-analyses. J Orthop Surg Res 2022; 17 (01) 425
- 24 Ziqi Z, Yufeng M, Lei Z, Chunsheng W, Pei Y, Kunzheng W. Therapeutic effects comparison and revision case analysis of unicompartmental knee arthroplasty and open wedge high tibial osteotomy in treating medial knee osteoarthritis in patients under 60 years: a 2-6-year follow-up study. Orthop Surg 2020; 12 (06) 1635-1643
- 25 Gupta R, Dudeja V, Bansal H, Kapoor A. Accelerated postoperative rehabilitation protocol for medial open wedge high tibial osteotomy enhances early return to routine activities. J Clin Orthop Trauma 2024; 57: 102563
- 26 Takeuchi R, Umemoto Y, Aratake M. et al. A mid term comparison of open wedge high tibial osteotomy vs unicompartmental knee arthroplasty for medial compartment osteoarthritis of the knee. J Orthop Surg Res 2010; 5 (01) 65
- 27 Ferrer Rivero R, Pujol O, Ferrer Rivero J, Oliver Far G. Closing wedge high tibial osteotomy: an old-fashioned technique? Survival, clinical and radiological outcomes of a case series analysis. Rev Esp Cir Ortop Traumatol 2024; 68 (04) 336-343
- 28 Meretta BM, Whitney SL, Marchetti GF, Sparto PJ, Muirhead RJ. The five times sit to stand test: responsiveness to change and concurrent validity in adults undergoing vestibular rehabilitation. J Vestib Res 2006; 16 (4-5): 233-243
- 29 Murao M, Nankaku M, Kawano T. et al. Reproducibility, criterion-related validity, and minimal clinically important difference of the stair negotiation test after total hip arthroplasty. Physiother Theory Pract 2023; 39 (11) 2438-2445
- 30 Pascale W, Luraghi S, Perico L, Pascale V. Do microfractures improve high tibial osteotomy outcome?. Orthopedics 2011; 34 (07) e251-e255
- 31 van den Bekerom MP, Patt TW, Rutten S, Raven EE, van de Vis HM, Albers GH. Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years. J Knee Surg 2007; 20 (04) 271-276