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Wu ZX, Ren WX, Wang ZQ. Proximal fibular osteotomy versus high tibial osteotomy for treating knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res 2022; 17:470. [PMID: 36307827 PMCID: PMC9617451 DOI: 10.1186/s13018-022-03299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) with varus alignment and medial space stenosis is a common degenerative disorder in the elderly. To reallocate the force bearing from the medial to the lateral compartment, the anti-varus osteotomy, including high tibial osteotomy (HTO) and proximal fibular osteotomy (PFO), corrects the mechanical lines of lower extremities using surgical methods, which alleviates the abrasion of medial cartilage and relieves pain. PFO is based on the "non-uniform settlement" theory. It is to cut small section of the proximal fibula, i.e., below the fibula head, which breaks the fibula and weakens its support for the lateral of the tibial plateau, lastly reduces the gap on the lateral side of the knee joint and offsets the knee varus deformity caused by weight bearing. We conducted this systematic review and meta-analysis to compare the clinical outcomes of PFO versus HTO intervention. METHODS Twenty-three studies were acquired from PubMed, Embase, CNKI (China National Knowledge Infrastructure), Wanfang Database and Cochrane Library. The data were extracted by two of the coauthors independently and were analyzed by RevMan5.3. Mean differences (MDs), odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration's Risk of Bias Tool and Newcastle-Ottawa Scale were used to assess risk of bias. RESULTS Twenty-three studies including 14 randomized controlled trials and 9 observational studies were assessed. The methodological quality of the trials ranged from low to high. The pooled results of the mean operation time (MD = - 38.75, 95% CI = - 45.66 to - 31.85, P < 0.00001), intraoperative bleeding (std. MD = - 4.12, 95% CI = - 5 to - 3.24, P < 0.00001), length of hospital stay (MD = - 3.77, 95% CI = - 4.98 to - 2.56, P < 0.00001) and postoperative complications (OR = 0.66, 95% CI = 0.37-1.18, P = 0.16) showed that the differences were statistically significant between the two interventions. The postoperative differences of visual analogue score (VAS) (MD = 0.15 95% CI = - 0.39 to 0.69, P = 0.58), hospital for Special Surgery knee score (HSS) (MD = - 2.68, 95% CI = - 6.30 to 0.94, P = 0.15), American knee society (AKS) score (MD = 0.04, 95% CI = - 0.69 to 0.77, P = 0.91), western Ontario and McMaster university of orthopedic index (WOMAC) (MD = 8.09, 95% CI = 2.06-14.13, P = 0.009) and femur-tibia angle (FTA) (MD = - 0.03, 95% CI = - 5.39 to 5.33, P = 0.99) were not statistically significant. Sensitivity analysis proved the stability of the pooled results and the publication bias was not apparent. CONCLUSIONS PFO and HTO have the same short-term efficacy in the treatment of KOA, but PFO can reduce the operation time, intraoperative bleeding, hospital stay and postoperative complications, which has certain advantages. Clinically, for patients with many complications and poor surgical tolerance, PFO can be preferred.
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Affiliation(s)
- Zhan-Xiong Wu
- Department of Orthopedics, Shanxi Bethune Hospital and Shanxi Academy of Medical Sciences, No.99, Longcheng street, Xiaodian District, Taiyuan, 030009, Shanxi Province, People's Republic of China.
| | - Wen-Xia Ren
- Department of Orthopedics, Shanxi Bethune Hospital and Shanxi Academy of Medical Sciences, No.99, Longcheng street, Xiaodian District, Taiyuan, 030009, Shanxi Province, People's Republic of China
| | - Zhi-Qiang Wang
- Department of Orthopedics, Shanxi Bethune Hospital and Shanxi Academy of Medical Sciences, No.99, Longcheng street, Xiaodian District, Taiyuan, 030009, Shanxi Province, People's Republic of China
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Zhang W, Liu FQ, Zhang LP, Ding HG, Zhuge YZ, Wang JT, Li L, Wang GC, Wu H, Li H, Cao GH, Lu XF, Kong DR, Sun L, Wu W, Sun JH, Liu JT, Zhu H, Li DL, Guo WH, Xue H, Wang Y, Gengzang CJC, Zhao T, Yuan M, Liu SR, Huan H, Niu M, Li X, Ma J, Zhu QL, Guo WW, Zhang KP, Zhu XL, Huang BR, Li JN, Wang WD, Yi HF, Zhang Q, Gao L, Zhang G, Zhao ZW, Xiong K, Wang ZX, Shan H, Li MS, Zhang XQ, Shi HB, Hu XG, Zhu KS, Zhang ZG, Jiang H, Zhao JB, Huang MS, Shen WY, Zhang L, Xie F, Li ZW, Hou CL, Hu SJ, Lu JW, Cui XD, Lu T, Yang SS, Liu W, Shi JP, Lei YM, Bao JL, Wang T, Ren WX, Zhu XL, Wang Y, Yu L, Yu Q, Xiang HL, Luo WW, Qi XL. [Status of HVPG clinical application in China in 2021]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:637-643. [PMID: 36038326 DOI: 10.3760/cma.j.cn501113-20220302-00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.
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Affiliation(s)
- W Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - F Q Liu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - L P Zhang
- Department of Radiology,Third Hospital of Taiyuan, Taiyuan 030012, China
| | - H G Ding
- Liver Disease Digestive Center,Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Y Z Zhuge
- Digestive Department,Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - J T Wang
- Department of Hepatobiliary Surgery, Xingtai People's Hospital, Xingtai 054001, China
| | - L Li
- Department of Interventional Radiology, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - G C Wang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - H Wu
- Digestive Department, West China Hospital, Sichuan University, Chengdu 610044, China
| | - H Li
- Institute of Hepatology and Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - G H Cao
- Department of Radiology, Shulan Hospital, Hangzhou 310022, China
| | - X F Lu
- Digestive Department, West China Hospital, Sichuan University, Chengdu 610044, China
| | - D R Kong
- Digestive Department, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - L Sun
- Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325001, China
| | - W Wu
- Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325001, China
| | - J H Sun
- Hepatobiliary and Pancreatic Intervention Center , the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - J T Liu
- Digestive Department,Hainan Hospital of Chinese PLA General Hospital, Sanya 572013, China
| | - H Zhu
- The 1 st Department of Interventional Radiology, the Sixth People's Hospital of Shenyang, Shenyang 110006, China
| | - D L Li
- No. 900 Hospital of the Joint Logistic Support Force, Fuzhou 350025, China
| | - W H Guo
- Department of Interventional Radiology, Meng Chao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China
| | - H Xue
- Digestive Department, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y Wang
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - C J C Gengzang
- Department of Interventional Radiology, the Fourth People's Hospital of Qinghai Province, Xining 810007, China
| | - T Zhao
- Department of Radiology,Sir Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China
| | - M Yuan
- Department of Interventional Radiology Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - S R Liu
- Department of Infectious Disease,Qufu People's Hospital, Qufu 273199, China
| | - H Huan
- Digestive Department, Chengdu Office Hospital of Tibet Autonomous Region People's Government, Chengdu 610041, China
| | - M Niu
- Department of Interventional Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - X Li
- Department of Radiology,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Ma
- Department of Interventional Vascular Surgerg, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
| | - Q L Zhu
- Digestive Department,the Affiliated Hospital of Southwest Medical University, Luzhou 646099, China
| | - W W Guo
- Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - K P Zhang
- Department of Hepatobiliary Surgery, Xingtai People's Hospital, Xingtai 054001, China
| | - X L Zhu
- Department of Surgery, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - B R Huang
- Department of Interventional Vascular Surgery,Jingzhou First People's Hospital, Jingzhou, China
| | - J N Li
- Liver Diseases Department,Jiamusi Infectious Disease Hospital, Jiamusi 154015, China
| | - W D Wang
- Hepatobiliary, Pancreatic and Spleen Surgery Department,Shunde Hospital, Southern Medical University, Foshan 528427, China
| | - H F Yi
- Digestive Department,Wuhan First Hospital, Wuhan 430030, China
| | - Q Zhang
- Interventional Vascular Surgery Department, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009, China
| | - L Gao
- Oncology and Vascular Interventional Department, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - G Zhang
- Digestive Department, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530016, China
| | - Z W Zhao
- Department of Interventional Radiology, Lishui Municipal Central Hospital, Zhejiang University School of Medicine, Lishui 323030, China
| | - K Xiong
- Digestive Department, the Second Affiliated Hospital of Nanchang University, Nanchang 330008, China
| | - Z X Wang
- Inner Mongolia Medical University Affiliated Hospital, Hohhot 010050, China
| | - H Shan
- Interventional Medicine Center, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - M S Li
- Department of Endovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - X Q Zhang
- Digestive Department, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - H B Shi
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X G Hu
- Interventional Radiology Department,Jinhua Municipal Central Hospital, Jinhua 321099, China
| | - K S Zhu
- Interventional Radiology Department, the Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510260, China
| | - Z G Zhang
- Department of Liver Surgery,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - H Jiang
- Infectious Disease Department,Second Affiliated Hospital, Military Medical University of the Air Force, Xi'an 710038, China
| | - J B Zhao
- Department of Vascular and Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - M S Huang
- Interventional Radiology Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China
| | - W Y Shen
- Digestive Department,Fuling Hospital Affiliated to Chongqing University, Chongqing 400030, China
| | - L Zhang
- Hepatobiliary Pancreatic Center,Tsinghua Changgung Hospital, Beijing 102200, China
| | - F Xie
- Function Department,Lanzhou Second People's Hospital, Lanzhou 730030, China
| | - Z W Li
- Hepatobiliary Surgery Department,Shenzhen Third People's Hospital, Shenzhen518112, China
| | - C L Hou
- Department of Interventional Radiology, the First Affiliated Hospital of USTC, Hefei 230001, China
| | - S J Hu
- Digestive Department,People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
| | - J W Lu
- Department of Interventional Radiology, Qufu People's Hospital, Qufu 273199, China
| | - X D Cui
- Department of Interventional Radiology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530016, China
| | - T Lu
- Department of Gastroenterology, Yangquan Third People's Hospital, Yangquan 045099,China
| | - S S Yang
- Department of Gastroenterology, General Hospital of Ningxia Medical University , Yinchuan 750003, China
| | - W Liu
- Department of Interventional Radiology, Lishui People's Hospital, Zhejiang Province, Lishui 323050, China
| | - J P Shi
- Department of Liver Diseases, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Y M Lei
- Interventional Radiology Department, People's Hospital of Tibet Autonomous Region, Lhasa 850001, China
| | - J L Bao
- Department of Gastroenterology, Shannan people's Hospital,Shannan 856004, China
| | - T Wang
- Department of Interventional Radiology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264099,China
| | - W X Ren
- Interventional Treatment Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011,China
| | - X L Zhu
- Interventional Radiology Department, the First Affiliated Hospital of Suzhou University, Suzhou 215006, China
| | - Y Wang
- Department of Interventional Vascular Surgery, the Second Affiliated Hospital of Hainan Medical College, Haikou 570216, China
| | - L Yu
- Department of Interventional Radiology, Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365001,China
| | - Q Yu
- Interventional Radiology Department, Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - H L Xiang
- Department of Gastroenterology, Tianjin Third Central Hospital, Tianjin 300170, China
| | - W W Luo
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - X L Qi
- Center of Portal Hypertension Department of Radiology, Zhongda Hospital of Southeast University, Nanjing 210009, China
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