Journal List > J Korean Orthop Assoc > v.45(4) > 1013005

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

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.

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.
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Table 1
Intraoperative Grading Criteria of Degenerative Change (Adapted from Stern et al.)
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Table 2
Clinical Results
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*Wilcoxon signed-rank test, Kruskal-Wallis test.

Table 3
Comparison of Results according to Degenerative Changes of Patellofemoral Joint
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*Mann-Whitney U test.

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