Summary: Patellofemoral osteoarthritis is not a contraindication for doing femorotibial UKA, and it has to be treated in a systematic and stagged manner according to its severity.

Introduction

Associated patellofemoral osteoarthritis was classically considered a contraindication for doing unicompartmental knee replacement (UKA) as treatment of femorotibial osteoarthritis, but nowadays this is discussed. The purpose of this article is to examine the functional results, complications and survivorship at midterm of medial or lateral UKA as treatment of femorotibial osteoarthritis, regardless the presence of clinical or radiographic signs of patellofemoral osteoarthritis.

Material And Methods

Retrospective comparative report of patients operated with medial or lateral UKA, despite of the presence of patellofemoral osteoarthritis, with a minimum follow up of 1 year. The patients were classified in groups depending on the patellofemoral osteoarthritis severity valued intraoperatively according to Outerbridge classification. We evaluate the clinical and functional results using the KSS score 2011. In all cases, the patellofemoral osteoarthritis was treated in a systematic and stagged manner with chondral shaving, microfractures, lateral release or lateral patellar facetectomy. Rate of complications and prosthesis survivorship were studied. The ANOVA test and the Kruskal-Wallis test were used with

Significance

level of 5%.

Results

We identified 110 UKA, 81 medial UKA (73.6%) and 29 lateral UKA (26.4%), with a mean follow up of 6 years (1-19.5). Intraoperatively 22 knees (20%) had patellofemoral chondropathy grade 2 according Outerbridge, 59 (53.6%) grade 3 and 29 (26.4%) grade 4. A statistically significant increase in KSS and range of motion was observed compared to the preoperative in the 3 groups. The clinical KSS and flexion contracture improvement were not different between the Outerbridge groups (p=0.07 and p=0.37 respectively). At least one Outerbridge group was different to the others with respect to functional improvement of KSS and maximal flexion (p=0.04 and p=0.04 respectively). The clinical and functional parameters evaluated were not negatively affected by the degree of patellofemoral osteoarthritis. Three cases needed revision (2.7%) because of tibial component aseptic loosening and none were caused by patellofemoral symptoms. Five years survivorship was 100% for 64 arthroplasties, 97% at 7 years for 31 arthroplasties, 93% at 9 years for 15 arthroplasties and 89% at 12 years for 9 arthroplasties.

Discusion: The secondary or associated patellofemoral osteoarthritis occurs in the context of a primary medial or lateral femorotibial osteoarthritis, in which the femorotibial malalignment leads to a medial or lateral patellar hyperpressure. It is usually slightly incapacitating, the pain is internal or external femorotibial and there is clinical-imaging dissociation associated with coronal misalignment. The treatment of the femorotibial osteoarthritis with UKA restores the primitive varus or valgus alignment and leads to clinical upgrade, because patellar alignment improves. Patellofemoral osteoarthritis is asymptomatic in an important proportion of patients, as it is reported in different studies, including our results.

Conclusion

Medial or lateral UKA as treatment for femorotibial osteoarthritis, regardless patellofemoral osteoarthritis, is a safe procedure, with low complication rates and excellent midterm results. Patellofemoral osteoarthritis is not a contraindication for doing UKA, and it has to be treated in a systematic and stagged manner according to its severity.
Proper patient selection, rigorous surgical technique, and trained surgeons are essential to obtain reproducible results.

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Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA
Time-Driven Activity-Based Costs for Manipulation Under Anesthesia after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES John Mazzocco, MD, UNITED STATES Lauren Schoeller, BS, UNITED STATES Ruijia Niu, MPH, UNITED STATES Daniel C Sun, UNITED STATES Eric L. Smith, MD, UNITED STATES
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Hip-Knee-Ankle Angle Affects Medial and Lateral Tibiofemoral Compressive Forces More Significantly than Joint Line Obliquity in Patients Post Total Knee Arthroplasty ePoster Presentation David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA
How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN

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Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years.

Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years.

Introduction

Material And Methods

Significance

Results

Conclusion

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Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years.

Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years.

Introduction

Material And Methods

Significance

Results

Conclusion

More 2023 ISAKOS Congress Content