Compared to high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) is better to improve postoperative function scores and minimize complications in medial unicompartmental knee osteoarthritis, as deciphered from a recent study. Linke Huang et al. sought to explore clinical outcomes of HTO and UKA.For a relevant literature search, electronic databases like PubMed, Web of Science, CENTRAL, Embase, and Biosis Preview were explored in this systematic review and meta-analysis.

Studies that compared the post-surgical results between UKA and HTO in retrospective and prospective research were incorporated. Evaluation of walking speed, function score, pain, and revision to arthroplasty was done. For complications, odds ratio (OR) along with 95% confidence interval (CI) were estimated. For range of motion (ROM), weighted mean difference (MD) and 95% CI were measured. The quality of the studies was assessed. For the assessment of heterogeneity, sensitivity and subgroup analyses were carried out.

There were 6 prospective and 23 retrospective studies incorporated. For comparison, 3004 patients (3084 knees) were assessed. The patients in the HTO group exhibited complications at a rate that was noticeably higher than the UKA group (OR 4.88). The postoperative function scores in the HTO group were significantly lower contrasted to the UKA group, including the Lysholm score (MD, -2.78) and Hospital for Special Surgery score (MD, -2.80). HTO and mobile-bearing UKA had comparable postoperative ROM (MD, -3.78).

The study groups did not significantly differ in terms of revision to total knee arthroplasty (TKA), walking speed, and postoperative pain. In terms of improving post-surgery function scores and reducing complications, UKA is better than HTO. In comparison to HTO, Mobile-bearing UKA has a comparable ROM. Regarding TKA revision, pain relief, and walking speed, both UKA and HTO offer satisfactory clinical results. UKA seems to be more appropriate for the elderly, while HTO and mobile-bearing UKA are both feasible surgical alternatives for younger, more active people.