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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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
Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Palliative Arthroscopic Debridement with Continuous Irrigation for the Infection TKA of High Mortality Risk Patients ePoster Presentation Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Yoon Cheol Nam, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
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
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, MD, JAPAN
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, 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

More 2023 Congress Knee Arthroplasty ePosters

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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