2018, Vol. 2 Issue 3, Part B
Osteoarthritis is defined as a degenerative joint disease & it represents the failure of the diarthrodial joint. OA is the most common cause of chronic knee pain in persons over 45 years of age, and is the most common joint disorder. Management of Osteoarthritis of knee continue to pose a therapeutic challenge; because whatever be the treatment modality we cannot restore a normal knee and the damage done to the joint cartilage cannot be reverted by any means. Moreover, most of the patient comes for consultation, when substantial cartilage damage has already been done; & conservative treatment can no longer alleviate their symptoms. The purpose of surgical management is to reduce pain, increase function & improve overall symptoms, patient’s satisfaction being the fundamental goal. There are so many surgical options for alleviation of symptoms in Osteoarthritis of knee; but in this study we are comparing the results between arthroscopic procedures alone and arthroscopic procedures along with high tibial osteotomy (HTO).
Aim: To compare the results between arthroscopic procedures alone and arthroscopic procedures along with high tibial osteotomy (HTO).
Materials and Methods: This was the study, first of its kind, where comparison had been done between arthroscopic procedure v/s arthroscopy + HTO. In this study, we compared the results between arthroscopy alone v/s arthroscopy plus high tibial osteotomy. So, in all patients we did arthroscopic procedure, & if correction of weight bearing axis was to be done then we did HTO along with arthroscopy. This is the study, first of its kind, where comparison has been done between arthroscopic procedure v/s arthroscopy + HTO. For comparing the results, we have JOA (Japanese Orthopaedic Association) Scoring system for clinical evaluation.
Results and Discussion: In our series, 93.4% of patients in arthroscopy group had good to fair result and none of the patient had very good to excellent result; but in arthroscopy and HTO group 40% of patients had very good and another 40% of patients had excellent result. From our series we can say that patients with medial compartment OA knee are benefited from arthroscopic procedures alone and arthroscopy with HTO. But, because of added benefit of correction of weight bearing axis in the second group, relief of symptoms is more and long lasting in arthroscopy & HTO group.
Conclusion: Arthroscopy plus high tibial osteotomy is a good alternative to unicompartment or total knee arthroplasty in patients with unicompartment OA knee; & in patients who want to preserve their natural joint. As, this is a small series and we have taken only 15 patients in each group; large series is required to confirm our results.