High tibial osteotomy or total knee arthroplasty in treatment of osteoarthritis of the knee joint

In this cross-sectional study; in order to evaluate the subjective and objective effects of High Tibial Osteotomy (HTO) and Total Knee Arthroplasty (TKA) operations on the same patient, 11 cases undergone these operations on each knee in different time periods were retrospectively reviewed. The mean age was 63 for HTO and 68 for TKA at the time of operations. There were 1 man and 10 women. Mean follow-up was 7.6 Years for HTO, 3.6 years for TKA. Subjective evaluation form of the knee which includek patient satisfaction, symptoms and visual analog score for pain and objective clinical evaluation by "Knee Society"s scores were used. Radioghraphic evaluation of both knees and EMG studies of muscle groups of both lower extremities were also performed. Six of the patients (55%) was more satisfied from the TKA side. The improvement of visual analog score for pain were equal in both groups (76% 78%). Although the follow up periods were different; the mean range of motion (ROM) after HTO were better (100° and 88°), but the residual patello-Femoral problems were the mean complaint after HTO they were noticeable greater than after the TKA (63% and 10%). Also, symptoms related to the lateral compartment were greater in the HTO group. In both groups no significant differencies were obtained with respect to the "Knee society"s scores. According to the EMG evaluation; HTO side was apparently better for the muscle physiology because the vastus medialis and vastus lateralis latencies were longer and patellar reflex amplitudes were lower on the TKA side. Although there has been a great difference in the post-operative period, we saw that, HTO sides have significantly more problems about lateral compartment and patellofemoral woint, but on the other hand, it is advantageous to conserve proprioception, ROM and potential longevity of the results.