High tibial osteotomy plus arthroscopic surgery for medial gonarthrosis / 中华创伤骨科杂志

ABSTRACT

Objective:To evaluate the clinical efficacy of high tibial osteotomy(HTO) plus arthroscopic surgery in the treatment of medial gonarthrosis.Methods:From January 2017 to May 2018, 40 patients were treated at Department of Joint Orthopaedics, Wujin Hospital Affiliated to Jiangsu University and at Department of Joint Orthopaedics, The First Affiliated Hospital to China Medical University for medial gonarthrosis. They were divided into 2 groups according to their different treatment methods. Group A was treated by HTO plus arthroscopic surgery; there were 20 cases, 8 males and 12 females with an age of 59.7 years ± 5.5 years. Group B was treated by only HTO; there were also 20 cases, 10 males and 10 females with an age of 58.2 years ± 4.3 years. The 2 groups were compared in terms of Hospital for Special Surgery (HSS) knee score, visual analogue scale (VAS), hip knee ankle angle (HKA), medial proximal tibia angle (MPTA) and posterior tibial slope angle (PTSA) at 6, 12 and 24 months postoperatively and at the last follow-up.Results:The 2 groups were comparable because there were no significant differences between them in the preoperative general data ( P>0.05). The HSS and VAS scores at 6 months after operation in group A (82.7±2.4 and 1.7±0.7) were significantly better than those in group B (78.4±2.6 and 2.2±0.8) ( P<0.05); the HSS score at 12 months after operation in group A (88.1±1.8) was significantly better than that in group B (82.9±1.7) ( P<0.05). There were no significant differences between the 2 group in the VAS score at 12 months after operation, or in the HSS or VAS scores at 24 months or at the last follow-up ( P>0.05). There were no significant differences either in the HKA, MPTA or PTSA scores between postoperative 6, 12, 24 months and the last follow-up ( P>0.05). Conclusion:In the treatment of medial gonarthrosis, high tibial osteotomy plus arthroscopic surgery may lead to better short-term outcomes than high tibial osteotomy alone, but the 2 methods may result in similar curative efficacy by 24 months after surgery.