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首页> 外文OA文献 >Is a high tibial osteotomy (HTO) superior to non-surgical treatment in patients with varus malaligned medial knee osteoarthritis (OA)?: A propensity matched study using 2 randomized controlled trial (RCT) datasets
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Is a high tibial osteotomy (HTO) superior to non-surgical treatment in patients with varus malaligned medial knee osteoarthritis (OA)?: A propensity matched study using 2 randomized controlled trial (RCT) datasets

机译：内翻畸形内侧膝骨关节炎（OA）患者的胫骨高度截骨术（HTO）是否优于非手术治疗？：一项使用2个随机对照试验（RCT）数据集进行的倾向匹配研究

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textabstractObjective: No randomized controlled trial (RCT) has compared the high tibial osteotomy (HTO) with non-surgical treatment in patients with medial knee osteoarthritis (OA) and varus malalignment. The aim was to compare the effectiveness of an unloader brace treatment or a usual care program to the HTO regarding pain severity and knee function. Design: Surgical treatment (HTO) to two non-surgical options was compared by combining the data of two RCTs. One RCT (n = 117) compared an unloader brace to usual care treatment; the other RCT (n = 92) compared closing to opening wedge HTO. One-to-many propensity score matching was used to equalize patient characteristics. We compared clinical outcome at 1 year follow-up (VAS pain (0-10) and knee function (HSS, 0-100)) with mixed model analysis. Results: Propensity score matching resulted in a comparison of 30 brace patient with 83 HTO patients, and of 28 usual care patients with 71 HTO patients. Pain at 1 year after HTO (VAS 3.8) was lower than after valgus bracing (VAS 5.0) with a mean difference of -1.1 (95% CI -2.2; -0.1). Function showed a nonsignificant mean difference of 2.1 [95% CI -3.1; 7.3]. Comparing HTO to usual care a difference was seen in pain (-1.7 [95% CI -2.8; -0.6]) and function (6.6 [95% CI 0.2; 13.1]), in favor of the HTO. Conclusions: Our data suggest that HTO was more effective in pain reduction compared to both non-surgical treatments. Function improved only when HTO was compared to usual care treatment. These small differences question the benefits of surgical treatment over the brace treatment.
机译：目的：尚无随机对照试验（RCT）将中胫骨内侧关节炎（OA）和内翻畸形患者的高胫骨截骨术（HTO）与非手术治疗进行比较。目的是比较HTO卸荷支架治疗或常规护理程序在疼痛严重程度和膝盖功能方面的有效性。设计：通过合并两个RCT的数据，比较了针对两种非手术选择的手术治疗（HTO）。一项RCT（n = 117）将卸荷器支架与常规护理进行了比较。另一个RCT（n = 92）与闭合楔形HTO进行了比较。一对多倾向评分匹配用于均衡患者特征。我们将1年随访的临床结果（VAS疼痛（0-10）和膝关节功能（HSS，0-100））与混合模型分析进行了比较。结果：倾向得分匹配结果将30例支架患者与83例HTO患者和28例常规护理患者与71例HTO患者进行了比较。 HTO后1年的疼痛（VAS 3.8）低于外翻支撑术后（VAS 5.0），平均差异为-1.1（95％CI -2.2; -0.1）。功能显示平均差异不显着2.1 [95％CI -3.1; 7.3]。将HTO与常规护理进行比较，发现疼痛（-1.7 [95％CI -2.8; -0.6]）和功能（6.6 [95％CI 0.2; 13.1]）有所不同，从而有利于HTO。结论：我们的数据表明，与两种非手术治疗相比，HTO在减轻疼痛方面更有效。仅当将HTO与常规护理治疗进行比较时，功能才能改善。这些小的差异使手术治疗优于支架治疗的益处受到质疑。

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