Treatment of Spontaneous Osteonecrosis of the Knee Using the Oxford Unicompartmental Knee Arthroplasty

Ji Hoon Bae; Hong Chul Lim; Sung Kwang Chun

doi:10.4055/jkoa.2008.43.3.287

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Bae, Lim, and Chun: Treatment of Spontaneous Osteonecrosis of the Knee Using the Oxford Unicompartmental Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(3): 287-293.

Published online: 30 June 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.3.287

Treatment of Spontaneous Osteonecrosis of the Knee Using the Oxford Unicompartmental Knee Arthroplasty

Ji Hoon Bae, M.D., Hong Chul Lim, M.D., Sung Kwang Chun, M.D.

Department of Orthopedic Surgery, Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Address reprint requests to Hong Chul Lim, M.D. Department of Orthopaedic Surgery, Guro Hospital, Korea University, 80, Guro-2dong, Guro-gu, Seoul 152-703, Korea. Tel: +82-2-2626-3084, Fax: +82-2-2626-1164, lhc2455@paran.com

Abstract

Purpose

The purpose of this study was to evaluate the clinical and radiographic outcomes of unicompartmental knee arthroplasty (UKA) in patients with spontaneous osteonecrosis.

Materials and Methods

Between September 2002 and March 2005, 15 patients with 16 knees were treated with UKA for the treatment of spontaneous osteonecrosis. There were thirteen women and two men with a mean age of 64 years old. The clinical assessment was performed using the American Knee Society Score system. The preoperative radiography was analyzed according to the size and stage of the osteonecrotic lesion and the osteoarthritic changes. Postoperatively, the presence of new osteonecrotic lesion, loosening of the implant, subsidence and arthritic changes was recorded.

Results

The mean preoperative knee score and the knee function score was improved from 52.5 to 89.2 and 56.0 to 85.2, respectively. There was no new necrotic lesion in the lateral compartment, loosening of the implant, subsidence or arthritic change.

Conclusion

UKA in patients with spontaneous osteonecrosis provided satisfactory clinical and radiological results in the short to medium term.

Keywords: Knee, Spontaneous osteonecrosis, Unicompartmental arthroplasty

Figures and Tables

Fig. 1

The condylar ratio and the size of the necrotic lesion can be measured on the AP and lateral radiographs. (A) The condylar ratio=b/a×100 (%) and (B) the size of the necrotic lesion=b×c (cm²).

Fig. 2

Radiographs of a 64-year-old woman who had a sudden onset of pain. (A) Anteroposterior radiograph showing the osteonecrotic lesion involving 53% of the medial femoral condyle. (B) Lateral radiograph showing radiolucent lesion with a sclerotic halo and an irregular articular surface. (C) T1-weighted MR coronal image showing the flattened articular surface with formation of a large subchondral multilobulated cyst in the medial femoral condyle. (D) T1-weighted MR sagittal image showing osteonecrotic lesion of the medial femoral condyle.

Fig. 3

(A) and (B) 3 years after Oxford unicompartmental knee arthroplasty. There was no new necrotic lesion or implant failure.

Table 1

Demographic Data of the Patients with Spontaneous Osteonecrosis of the Knee Treated with Unicompartmental Knee Arthroplasty

Table 2

Koshino's Staging of Spontaneous Osteonecrosis

Table 3

Clinical Results according to the American Knee Society Score

^*p<0.001, ^†p>0.05, ^‡p>0.05.

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