2025 ISAKOS Biennial Congress ePoster
Conversion To Total Knee Arthroplasty Following High Tibial Osteotomy And Unicompartmental Knee Arthroplasty: A Propensity-Matched Analysis
Griffith G. Gosnell, MS, Potomac, MD UNITED STATES
Katherine L. Esser, BS, New York, NY UNITED STATES
Michael Moore, BA, New York City, New York UNITED STATES
Nathaniel P. Mercer, MD, New York, New York UNITED STATES
Heath Patrick Gould, MD, Grand Forks, ND UNITED STATES
Laith M. Jazrawi, MD, New York, NY UNITED STATES
Eric Strauss, Scarsdale, NY UNITED STATES
Michael J Alaia, MD, New York, New York UNITED STATES
NYU Langone Orthopedics, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
A propensity-matched analysis revealed no significant difference in the rates of conversion to total knee arthroplasty (TKA) between high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA), indicating both procedures are equally viable options to delay TKA in patients with isolated compartment knee osteoarthritis.
Abstract
Introduction
High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are established surgical interventions for the management of isolated medial or lateral compartment knee osteoarthritis. Both procedures aim to improve knee function while delaying (or, in some cases, preventing) the need for total knee arthroplasty (TKA) in the future. Despite the widespread application of these techniques, the comparative progression of HTO and UKA to TKA remains unknown. This study sought to compare rates of TKA in patients following HTO and UKA.
Methods
A retrospective cohort study was conducted, including 96 patients who underwent either HTO or UKA. Patients were matched 1:1 using propensity scores based on age, sex, body mass index (BMI), race, and Charlson Comorbidity Index (CCI). The primary outcome measure was the progression to TKA, defined as the subsequent need for conversion to TKA. Statistical analyses were performed using Fisher’s exact tests to compare the incidence of TKA between the two groups, with statistical significance set at p < 0.05.
Results
The baseline characteristics between the HTO and UKA cohorts were well-matched, with no statistically significant differences in age, sex distribution, BMI, race, or Charlson Comorbidity Index (CCI) scores. Within these propensity-matched cohorts, 4 patients (8.33%) in the HTO group progressed to TKA, compared to 6 patients (12.5%) in the UKA group (Table 1). Statistical analysis revealed no significant difference in TKA conversion rates between the groups (p = 0.74).
Conclusion
This propensity-matched analysis found no statistically significant difference in the progression to TKA between patients undergoing HTO versus UKA. Our findings suggest that both procedures are viable options in the management of isolated medial or lateral compartment arthritis. Thus, surgeons should consider addressing both procedures in their preoperative discussion to reach a treatment decision through shared decision-making with the patient.