No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis

Song, Eun-Kyoo; Park, Ju-Kwon; Park, Chan Hee; Kim, Min‐Cheol; Agrawal, Pranav R.; Seon, Jong Keun

doi:10.1007/s00167-014-3367-9

Cited by 45 publications

(27 citation statements)

References 24 publications

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“…Kozinn and Scott proposed that UKA should not be offered to patients with PF joint arthritis for optimal results (31). This sparked a contentious debate on PF joint disease because other authors demonstrated only a weak correlation between PF degenerative changes and anterior knee pain (11,32).…”

Section: Discussionmentioning

confidence: 99%

Effects of contact stress on patellarfemoral joint and quadriceps force in fixed and mobile-bearing medial unicompartmental knee arthroplasty

Kwon

Lee

Koh

et al. 2020

Preprint

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Background Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage, symptomatic unicompartmental osteoarthritis of the knee joint. However, patellofemoral joint degeneration is a contraindication to medial UKA. Therefore, the objective of this study was to evaluate the biomechanical effect of medial UKA using fixed-bearing (FB) and mobile-bearing (MB) design prostheses on the patellofemoral joint. Methods A three-dimensional finite-element model of a normal knee joint was developed using medical image data. We performed statistical analysis for each model. The differences in contact stress on the patellofemoral joint and the quadriceps force between the FB and MB designs were evaluated under a deep-knee-bend condition.Results At an early flexion angle, the results of contact stress showed no significant difference between the FB and MB medial UKA models and the intact model. However, at large flexion angles, we observed a significant increase in contact stress with the FB models. On the contrary, in the case of the MB models, we found no statistically significant increment compared with the intact model. Our results indicate that with medial UKA, the contact stress increased and greater quadriceps force was applied to the patellofemoral joint. However, performing UKA on a patellofemoral joint with osteoarthritis should not be difficult, unless anterior knee pain is present, because the increase in contact stress is negligible. Conclusions Our results show no significant difference in contact stress on the patellofemoral joint between the medial UKA and intact knee joint models. Such a mechanism was easily found in MB medial UKA. Therefore, this study biomechanically showed that degenerative changes in the patellofemoral joint should not be considered an absolute contraindication to treatment with medial UKA.

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Section: Discussionmentioning

confidence: 99%

Effects of contact stress on patellarfemoral joint and quadriceps force in fixed and mobile-bearing medial unicompartmental knee arthroplasty

Kwon

Lee

Koh

et al. 2020

Preprint

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“…1 Also, similar results were shown that there was no significant difference in functional outcomes including anterior knee pain regardless of the presence or absence of OA in the patellofemoral joint. 1 However, some authors have concluded that the primary mode of failure of UKA was progressive PF OA which requires conversion to TKA. 4,5 Structural abnormalities in the subchondral bone are key factors in the pathogenesis of OA.…”

Section: Discussionmentioning

confidence: 99%

Influence of Bone Marrow Edema on Medial Unicompartmental Knee Arthroplasty among Patients with Patellofemoral Osteoarthritis

Yue

et al. 2017

J Knee Surg

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This study aims to compare clinical outcomes in unicompartmental knee arthroplasty (UKA) patients with or without magnetic resonance imaging (MRI) evidence of bone marrow edema (BME) in the patella and to evaluate the effect of functional outcomes after UKA in patients with patellofemoral osteoarthritis (PF OA). Outcomes of 146 knees in 141 patients who underwent medial UKA were included. According to their preoperative condition of patellofemoral joints, patients were divided into three groups: Group A, non-PF OA (Kellgren–Lawrence [K–L] scale = 0); group B, PF OA without BME (K–L ≥ 1, bone marrow edema pattern [BMEP] = 0); group C, PF OA with BME (K–L ≥ 1, BMEP ≥ 1). Clinical outcomes including visual analog scale (VAS) scores of knee pain, Hospital for Special Surgery (HSS) scores, and range of motions (ROMs) were evaluated and analyzed at the postoperative follow-up of 3 months and 2 years. From our results, BME was highly correlated to poor outcome in patients with UKA. At follow-up of 3 months, BME influenced the clinical outcome of UKA at an early postoperative stage in terms of VAS scores, HSS scores, and ROMs. At the final follow-up of 2 years, the clinical outcome was improved in terms of HSS score, although the anterior knee pain and active ROMs were still worse than that of patients without BME. In conclusion, there was no significant difference in clinical outcomes in patients without BME regardless of PF OA. However, the condition of BME should be taken serious consideration because of its indication of an adverse effect on the outcome after UKA.

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“…It is not clear why impingement and osteoarthritic changes appeared to have been mutually exclusive [16] [17]. Since impingement is associated with anterior placement of the femoral component, this complication may protect the opposite portion of the patella by reducing the contact pressures on that side [18] [19] [20].…”

Section: Discussionmentioning

confidence: 99%

Patellofemoral Outcome after Medial Unicompartmental Knee Replacement: A Retrospective Study of 25 Cases

Naouar¹,

Kaziz²,

Mouelhi³

et al. 2017

OJO

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Introduction: Osteoarthritis and impingement, in patellofemoral compartment after partial arthroplasty, have been rarely reported. The purpose of our study was to evaluate outcome at long-term follow-up. Methods: We have reviewed retrospectively twenty-five unicompartmental arthroplasties. The medial parapatellar approach was used in all cases. Patients have been evaluated with regard to patellar impingement and osteoarthritic changes revealed by radiographs. The mean follow-up was 10.4 years. The clinical scoring system of the Knee Society and specific questions regarding patellofemoral symptoms were used for functional outcome. Patellofemoral complications such as osteoarthritis, impingement and the position of the femoral component were diagnosed on X-ray views of the knee. Results: At the final follow-up, fifteen knees revealed lateral patellofemoral osteoarthritis and four knees had patellofemoral impingement. Excepted of two cases, all knees with patella impingement did not revealed degenerative modifications. Anterior pain of the knee was noted more frequently in knees with patellar complications. Patellar impingement was considered the first cause of knee pain, more than knees with degenerative modifications. Only one revision surgery was indicated in front of patellofemoral conflict. The occurrence of patellar impingement depends on the surgical procedure. The anterior position of the femoral component seems to increase the frequency of such complication.

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No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis

Abstract: III.

Cited by 45 publications

References 24 publications

Effects of contact stress on patellarfemoral joint and quadriceps force in fixed and mobile-bearing medial unicompartmental knee arthroplasty

Effects of contact stress on patellarfemoral joint and quadriceps force in fixed and mobile-bearing medial unicompartmental knee arthroplasty

Influence of Bone Marrow Edema on Medial Unicompartmental Knee Arthroplasty among Patients with Patellofemoral Osteoarthritis

Patellofemoral Outcome after Medial Unicompartmental Knee Replacement: A Retrospective Study of 25 Cases

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