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Abstract：
OBJECTIVE: To validate the safety and clinical results of single-stage bilateral versus unilateral medial opening wedge high tibial osteotomy (HTO).
METHODS: A propensity-matched cohort study was performed from March 2020 to March 2021 in our medical center. Data were prospectively collected. Including 34 patients who underwent single-stage bilateral medial opening HTO(SSBHTO), and 68 cases in the unilateral group. Propensity-matched ration was 2:1 based on age, sex, and body mass index using R software. Comparisons of the length of hospital stay, operative time, blood loss, postoperative adverse events, 90-day readmission rate, conversion to TKA rate, self-reported VAS and WOMAC scores were made to investigate the safety and clinical results of bilateral HTO.
RESULTS: The mean length of hospital stay was 7.36 ± 2.23 days for SSBHTO and 7 days (IQR, 3 days; range, 4 to 23 days) for the unilateral group (P = 0.219). The mean operative time was 144 ± 47 min for bilateral HTO and 105(37.5) mins for a unilateral OWHTO (P < 0.001). The mean blood loss was 150(100) ml for SSBHTO and 100(50) ml for unilateral OWHTO (P < 0.001). There were no significant difference of the adverse events and 90-day readmission rate between two groups. No failed HTO or conversion to knee arthroplasty were observed at the end of follow-up. VAS, pain, stiffness, and functional scores of the WOMAC scale were essentially comparable of two groups one year after surgery (P > 0.05).
CONCLUSIONS: A single-stage bilateral medial opening wedge high tibial osteotomy is advisable for patients with knee osteoarthritis. Patients benefit from avoiding secondary anesthesia, postoperative complications, and substantial cost savings.
METHODS: Therapeutic Level III.
METHODS: A propensity-matched cohort study was performed from March 2020 to March 2021 in our medical center. Data were prospectively collected. Including 34 patients who underwent single-stage bilateral medial opening HTO(SSBHTO), and 68 cases in the unilateral group. Propensity-matched ration was 2:1 based on age, sex, and body mass index using R software. Comparisons of the length of hospital stay, operative time, blood loss, postoperative adverse events, 90-day readmission rate, conversion to TKA rate, self-reported VAS and WOMAC scores were made to investigate the safety and clinical results of bilateral HTO.
RESULTS: The mean length of hospital stay was 7.36 ± 2.23 days for SSBHTO and 7 days (IQR, 3 days; range, 4 to 23 days) for the unilateral group (P = 0.219). The mean operative time was 144 ± 47 min for bilateral HTO and 105(37.5) mins for a unilateral OWHTO (P < 0.001). The mean blood loss was 150(100) ml for SSBHTO and 100(50) ml for unilateral OWHTO (P < 0.001). There were no significant difference of the adverse events and 90-day readmission rate between two groups. No failed HTO or conversion to knee arthroplasty were observed at the end of follow-up. VAS, pain, stiffness, and functional scores of the WOMAC scale were essentially comparable of two groups one year after surgery (P > 0.05).
CONCLUSIONS: A single-stage bilateral medial opening wedge high tibial osteotomy is advisable for patients with knee osteoarthritis. Patients benefit from avoiding secondary anesthesia, postoperative complications, and substantial cost savings.
METHODS: Therapeutic Level III.
摘要：
目的：验证单阶段双侧与单侧内侧开放楔形胫骨高位截骨术（HTO）的安全性和临床效果。
方法：一项倾向匹配队列研究于2020年3月至2021年3月在我们的医疗中心进行。数据是前瞻性收集的。包括34例接受单阶段双侧内侧开放HTO（SSBHTO）的患者，单侧组68例。基于年龄，倾向匹配比例为2：1，性别,和体重指数使用R软件。住院时间的比较，手术时间,失血,术后不良事件,90天再入院率，转换为TKA率，我们进行了自我报告的VAS和WOMAC评分,以调查双侧HTO的安全性和临床结果.
结果：SSBHTO的平均住院时间为7.36±2.23天，平均住院时间为7天（IQR，3天；范围，4至23天）为单侧组（P=0.219）。双侧HTO的平均手术时间为144±47分钟，单侧OWHTO的平均手术时间为105（37.5）分钟（P<0.001）。SSBHTO的平均失血量为150（100）ml，单侧OWHTO的平均失血量为100（50）ml（P<0.001）。两组患者的不良事件和90d再入院率差异无统计学意义。随访结束时，未观察到HTO失败或转换为膝关节置换术。VAS,疼痛,刚度,术后1年,两组WOMAC量表功能评分基本具有可比性(P>0.05)。
结论：膝关节骨性关节炎患者宜采用单阶段双侧内侧开口楔形胫骨高位截骨术。患者受益于避免二次麻醉，术后并发症,和大量的成本节约。
方法：治疗级别III。
方法：一项倾向匹配队列研究于2020年3月至2021年3月在我们的医疗中心进行。数据是前瞻性收集的。包括34例接受单阶段双侧内侧开放HTO（SSBHTO）的患者，单侧组68例。基于年龄，倾向匹配比例为2：1，性别,和体重指数使用R软件。住院时间的比较，手术时间,失血,术后不良事件,90天再入院率，转换为TKA率，我们进行了自我报告的VAS和WOMAC评分,以调查双侧HTO的安全性和临床结果.
结果：SSBHTO的平均住院时间为7.36±2.23天，平均住院时间为7天（IQR，3天；范围，4至23天）为单侧组（P=0.219）。双侧HTO的平均手术时间为144±47分钟，单侧OWHTO的平均手术时间为105（37.5）分钟（P<0.001）。SSBHTO的平均失血量为150（100）ml，单侧OWHTO的平均失血量为100（50）ml（P<0.001）。两组患者的不良事件和90d再入院率差异无统计学意义。随访结束时，未观察到HTO失败或转换为膝关节置换术。VAS,疼痛,刚度,术后1年,两组WOMAC量表功能评分基本具有可比性(P>0.05)。
结论：膝关节骨性关节炎患者宜采用单阶段双侧内侧开口楔形胫骨高位截骨术。患者受益于避免二次麻醉，术后并发症,和大量的成本节约。
方法：治疗级别III。
