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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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
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
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
Evaluation of The Safety And Efficacy of The Fully Automated Active Robotic System In Robotic Assisted Total Knee Arthroplasty ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Differences In Pain, Sleep Status And Functional Recovery Between TKA And UKA ePoster Presentation Takeo Mammoto, MD, JAPAN
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
In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity ePoster Presentation Eiichi Nakamura, MD, PhD, JAPAN Nobukazu Okamoto, MD, PhD, JAPAN Hitoshi Ito, MD, PhD, JAPAN Tetsurou Masuda, MD, PhD, JAPAN Satoshi Hisanaga, MD, PhD, JAPAN Yasunari Oniki, MD, PhD, JAPAN
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
Compliance and Outcome of Osteoporosis Treatment After Total Knee Arthroplasty ePoster Presentation Yun Seong Choi, MD, KOREA, REPUBLIC OF Seung Hoon Lee, MD, KOREA, REPUBLIC OF Jung Ro Yoon, MD, KOREA, REPUBLIC OF Young Bin Shin, MD, KOREA, REPUBLIC OF Tae Hyuk Yoon, MD, KOREA, REPUBLIC OF
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY

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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