The Influence of Symtomless Degenerative Changes of the Patellofemoral Joint on Clinical Results of Medial Unicompartmental Knee Arthroplasty

Kyung Tae Kim; Song Lee; Kwan Soo Kim; Tae Woo Kim; Soon Youl Park

doi:10.4055/jkoa.2010.45.4.287

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Kim, Lee, Kim, Kim, and Park: The Influence of Symtomless Degenerative Changes of the Patellofemoral Joint on Clinical Results of Medial Unicompartmental Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(4): 287-292.

Published online: 9 August 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.4.287

The Influence of Symtomless Degenerative Changes of the Patellofemoral Joint on Clinical Results of Medial Unicompartmental Knee Arthroplasty

Kyung Tae Kim, M.D., Song Lee, M.D., Kwan Soo Kim, M.D., Tae Woo Kim, M.D., Soon Youl Park, M.D.

Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.

Correspondence to: Kyung Tae Kim, M.D. Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, 40-12, Chungryangri-dong, Dongdaemoon-gu, Seoul 130-011, Korea. TEL: +82-2-966-1616, FAX: +82-2-968-2394, kktkimos@hanmail.net

Received 28 September 2009 Accepted 3 June 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the influence of degenerative changes in the patellofemoral joint on the clinical results of medial unicompartmental knee arthroplasty (UKA).

Materials and Methods

Between January and December 2002, we operated on 180 cases of minimally invasive UKA using the Oxford® phase 3. Of the 180 cases, 156 were followed up for a minimum period of 5 years. Based on intraoperative degenerative findings of the patellofemoral joint, we classified cases into 4 groups (Group I-78 cases, Group II-40 cases, Group III-27 cases, Group IV-11 cases), and the clinical data were analyzed prospectively.

Results

During follow-up, which averaged 6 years and 2 months, the knee score, the knee function score, the range of knee motion and the tibiofemoral angle were improved significantly (p<0.05) in all groups. The preoperative knee score and the tibiofemoral angle in the mild degeneration group (I, II) were higher than in the severe degeneration group (III, IV) (p<0.05). On the other hand, there were no significant differences between the groups in the postoperative knee score, the knee function score, the range of knee motion and the tibiofemoral angle (p>0.05). To date, no complication or failure involving the patellofemoral joint has been observed.

Conclusion

Clinical results of UKA are satisfactory for all groups, and the severity of patellofemoral degeneration has no influence on clinical outcome. Symptomless degenerative arthritis of the patellofemoral joint is not a contraindication for medial UKA.

Keywords: knee joint, medial compartment, patellofemoral joint, degenerative arthritis, unicompartmental arthroplasty

Figures and Tables

Figure 1

(A) Preoperative radiographs of a 61-year-old woman show osteoarthritis of the medial compartment and patellofemoral joint in the right knee. (B) The last follow-up radiographs, 6 years after Oxford® phase 3 unicompartmental knee arthroplasty, show no changes of the patellofemoral joint.

Table 1

Intraoperative Grading Criteria of Degenerative Change (Adapted from Stern et al.)

Table 2

Clinical Results

^*Wilcoxon signed-rank test, ^†Kruskal-Wallis test.

Table 3

Comparison of Results according to Degenerative Changes of Patellofemoral Joint

^*Mann-Whitney U test.

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