Preoperative Bone Marrow Edema Negatively Impacts 10-Year Outcomes After Unicompartmental Knee Arthroplasty

Yang, Hong-Yeol; Kwak, Woo-Kyoung; Song, Eun-Kyoo; Seon, Jong-Keun

doi:10.1016/j.arth.2022.10.010

Cited by 2 publications

(1 citation statement)

References 46 publications

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“…However, knee pain is closely associated with not only cartilage or OA status, but also with subchondral bone status including the presence of bone marrow lesions (BMLs) in patients with knee OA [8, 38, 41]. In addition, several studies showed that preoperative BMLs on the medial femoral or tibial condyles have been shown to persist after surgery and may affect postoperative pain after medial uni‐compartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO) [12, 14, 16, 43]. Similarly, in cases of patellar non‐resurfacing TKA, BMLs of the patella persist after TKA and may affect postoperative AKP.…”

Section: Introductionmentioning

confidence: 99%

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing

Jung Jung,

Kang,

Lee

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Residual anterior knee pain is one of the most common problems after total knee arthroplasty (TKA). However, the contributing factors afecting postoperative anterior knee pain (AKP) remain poorly understood. This study aimed to evaluate the efect of preoperative patellar bone marrow lesions (BMLs) and patellar cartilage defects on postoperative AKP after patellar non-resurfacing TKA. Methods This retrospective study included 336 patients who underwent unilateral TKA without patella resurfacing. All patients underwent preoperative magnetic resonance imaging (MRI) to assess the presence of BMLs and the degree of cartilage defects in the patella. Patients were categorized into four groups according to the presence of BMLs (with or without BMLs) and the degree of cartilage defects (with or without full thickness cartilage defects). The Kujala Anterior Knee Pain Scale (AKPS) and the Hospital for Special Surgery Knee Rating Scale (HSS) scores at 2 years after TKA were compared among the groups. Results Preoperative BMLs in the patella were found in 132 (39.3%) of 336 cases. Among the four groups, the group with both BMLs and full-thickness cartilage defects demonstrated signiicantly lower AKPS compared to the other groups at 2 years after TKA (p < 0.01), but no signiicant diference was shown in the HSS scores, between these groups. There were no signiicant diferences in either AKPS or HSS scores among the other three patient groups. Conclusions The presence of preoperative BMLs with full-thickness cartilage defects in the patella was associated with worse postoperative AKP after TKA without patella resurfacing. Patella resurfacing should be considered in this patient group to minimize the risk of developing residual AKP after TKA. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing

Jung Jung,

Kang,

Lee

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up

Kawada,

Yokoyama,

Okazaki

et al. 2024

Arch Orthop Trauma Surg

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Introduction The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs. Materials and methods This study analyzed 68 patients. The presence or absence of MMPRTs was evaluated using preoperative magnetic resonance imaging. Patient characteristics, clinical scores before surgery and at the final evaluation, and imaging findings were compared between patients with and without MMPRTs. Multiple regression analysis was conducted on postoperative visual analog scale (VAS)-pain scores. Results MMPRTs were present in 64.7% (44/68) of patients. Patients with MMPRTs were significantly younger (67.8 ± 8.2 vs. 75.0 ± 7.1 years, p < 0.001) and had a shorter duration from the development of symptoms to the time of surgery than those without (6.8 ± 8.4 vs. 36.1 ± 38.9 months, p < 0.001). Component placement or lower-limb alignment did not significantly differ between the groups. Preoperative clinical scores were not significantly different between the groups; however, patients with MMPRTs showed significantly better postoperative VAS-pain scores than those without (10.0 ± 9.0 vs. 28.2 ± 26.0 points, p = 0.026). Multiple regression analysis of postoperative VAS-pain scores revealed the significant effect of duration from the development of symptoms to the time of surgery (p = 0.038). Conclusions Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA.

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Preoperative Bone Marrow Edema Negatively Impacts 10-Year Outcomes After Unicompartmental Knee Arthroplasty

Cited by 2 publications

References 46 publications

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing

Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up

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