Effect of medial opening wedge high tibial osteotomy versus unicompartmental knee arthroplasty on mental health: a comparative study with propensity score-matched analysis.

Authors

Ashton Kai Shun Tan, Shaun Kai Kiat Chua, Shao Jin Teo, Xinyu Tao, Don Thong Siang Koh, Junwei Soong, Hamid Rahmatullah Bin Abd Razak, Kong Hwee Lee

Published in

Singapore medical journal. Aug 03, 2026. Epub Aug 03, 2026.

Abstract

Medial opening wedge high tibial osteotomy (MOWHTO) and unicompartmental knee arthroplasty (UKA) are established treatments for knee osteoarthritis (KOA). This study compared their effects on mental health outcomes.
A retrospective cohort study was conducted on patients who underwent MOWHTO or UKA between 2019 and 2023 at a single tertiary institution. The primary outcome measure, the Short Form-36 mental component score (SF-36 MCS), was recorded at baseline, six months and two years post-procedure. Secondary outcomes included the SF-36 physical component score (PCS) and the Oxford knee score (OKS). A total of 105 MOWHTO and 89 UKA procedures were performed. Propensity score matching accounted for preoperative scores, age, gender and body mass index, yielding 51 patients per group. Multivariable regression was used to examine associations between preoperative MCS and postoperative outcomes. Baseline predictors of postoperative MCS were analysed. The level of significance was set at P < 0.05.
At six months postoperatively, the UKA group demonstrated better PCS (MOWHTO 42.0 vs UKA 49.6, P < 0.001) and OKS (MOWHTO 23.0 vs UKA 18.8, P = 0.002). At two years, both groups achieved similar improvements in SF-36 MCS, SF-36 PCS and OKS. Preoperative MCS showed a moderate association with postoperative MCS and weak associations with postoperative PCS and OKS. Preoperative MCS was the only baseline factor independently associated with postoperative MCS.
In patients with KOA, MOWHTO and UKA achieved similar improvements in mental health scores at two years. Preoperative mental health is an important determinant of postoperative mental health, highlighting its importance in preoperative assessment and counselling.

PMID:
42542939
Bibliographic data and abstract were imported from PubMed on 02 Aug 2026.

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