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Effectiveness of gonarthrosis treatment in elderly patients – HTO vs TKA

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Treatment of gonarthrosis is also a main economic concern, pain and disability being associated with high costs. Resource allocation is challenging in times of economic restraint. Therapeutic sanction is nuanced depending on disease stage, patients age, its option and economic possibilities of the health system. Quite often, and especially in developing countries, treatment option is on economic considerations.
The aim of this study is to compare effectiveness of HTO and TKA as treatment procedures in elderly patients with gonarthrosis. This study reviewed 20 patients who underwent TKA and 15 patients who underwent HTO for degenerative arthritis of the knee. The effectiveness analysis was performed for both methods of treatment. Before and 1 year after surgery patients were interviewed by means of the EuroQol-5D and the KSS (Knee Society Score) and Range of Motion (ROM) score for knee was assessed for their individual benefit due to TKA or HTO.
Statistical tests were performed using SPSS software. The median EuroQol score rose from 41% (32 – 51%) before surgery to 75% (61 – 90%) after surgery (p<0,001), in case of TKA, and from 43% (31 – 53%) before surgery to 61% (40 – 68%) after surgery (p<0,001), in case of HTO. Our study results showed a significant improvement of KSS score in both groups postoperatively. There is a most significant improvement in TKA group. The EQ score rose significantly in both groups but with a greater increase in TKA group. The TKA is the method of choice in treating knee osteoarthritis, in older patients, with better long term results, despite the fact that it is more expensive than HTO. Abbreviations: HTO – high tibial osteotomy, TKA – total knee arthroplasty, KSS – Knee Society Score, ROM – Range of Motion score, EQ – EuroQol score, UKA-unicompartmental arthroplasty

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