Functional and Clinical Outcomes after Medial Unicompartmental Knee Arthroplasty Compared with High Tibial Osteotomy in Isolated Medial Compartment Osteoarthritis

Introduction: Medial compartment osteoarthritis (OA) causes pain, functional limitation, and reduced quality of life. When conservative treatment fails, surgical options include high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA), both aimed at pain relief and functional improvement. Materials and Methods: This prospective comparative study included 50 patients with isolated medial compartment OA, divided into UKA (n = 25) and HTO (n = 25) groups. Clinical parameters, including Visual Analog Scale (VAS) pain score, ROM, and post-operative complications, were analyzed, with P < 0.05 considered significant. Results: Most patients were males (60%) and aged 50-70 years (76%). Pre-operative VAS scores were comparable (UKA: 7.8 ± 0.9; HTO: 7.6 ± 1.0). Post-operatively, pain significantly decreased in both groups but was lower in UKA (2.1 ± 0.8 vs. 3.2 ± 1.0; P = 0.01). Functional outcomes were better in the UKA group (knee society score: 86.4 ± 6.5 vs. 79.2 ± 7.3), with greater improvement in ROM (125° vs. 118°). Most patients (88%) had no complications. Conclusion: Both HTO and UKA are effective for medial compartment OA; however, UKA provides superior functional outcomes and range of motion.