Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty

Abstract Background and objective The efficacy of medial unicompartmental knee arthroplasty (UKA) in patients with intraoperatively identified patellofemoral osteoarthritis (PFOA) has been a subject of debate. This retrospective study aimed to investigate the early outcomes of UKA in patients with v...

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Main Authors: Bei Li, Changyu Huang, Bingqian Zheng, Zida Huang, Xinyu Fang, Xiaoyong Wang, Wenming Zhang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-024-08270-8
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author Bei Li
Changyu Huang
Bingqian Zheng
Zida Huang
Xinyu Fang
Xiaoyong Wang
Wenming Zhang
author_facet Bei Li
Changyu Huang
Bingqian Zheng
Zida Huang
Xinyu Fang
Xiaoyong Wang
Wenming Zhang
author_sort Bei Li
collection DOAJ
description Abstract Background and objective The efficacy of medial unicompartmental knee arthroplasty (UKA) in patients with intraoperatively identified patellofemoral osteoarthritis (PFOA) has been a subject of debate. This retrospective study aimed to investigate the early outcomes of UKA in patients with varying intraoperative PFOA conditions and to explore the relationship between the location of PFOA and the position of the prosthesis post-UKA. Our aim was to determine whether the presence of PFOA affects the short-term success of medial UKA. Methods This single-center, retrospective study included patients who underwent UKA by a same surgical team from March 2021 to November 2022. Patients were categorized into normal, medial, middle, and lateral groups based on the intraoperative PFOA findings. A total of 103 patients were analyzed, with data collected on demographics, intraoperative details, and pre- and postoperative laboratory and imaging data. Patellofemoral joint cartilage damage was assessed using the Outerbridge classification. Postoperative patellofemoral joint function was evaluated using the Lonner score, Oxford Knee Score (OKS), and visual analog scale (VAS) for pain. Results Significant improvements were observed in postoperative Lonner pain scores, Lonner functional scores, OKS, and VAS compared to preoperative values for all groups (P < 0.05). Medial and middle PFOA identified intraoperatively did not affect the short-term efficacy of medial UKA. Although lateral PFOA had some impact on UKA efficacy, patients still experienced significant postoperative pain relief and functional improvement. Differences in the tibial component posterior slope angle (TCPSA) were noted among the groups, particularly between the medial and lateral groups (P < 0.05). Conclusion Intraoperatively identified medial and middle PFOA do not influence the short-term efficacy of medial UKA. Lateral PFOA has some impact on UKA outcomes, yet patients demonstrate significant improvements in postoperative pain and function. Intraoperative PFOA should not be considered an absolute contraindication for medial UKA. The study’s follow-up duration was relatively short, necessitating further research on the mid- to long-term effectiveness of UKA in patients with combined PFOA.
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spelling doaj-art-e48e0d683fbe4795898ba6fb6b467a502025-01-12T12:04:54ZengBMCBMC Musculoskeletal Disorders1471-24742025-01-012611810.1186/s12891-024-08270-8Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplastyBei Li0Changyu Huang1Bingqian Zheng2Zida Huang3Xinyu Fang4Xiaoyong Wang5Wenming Zhang6Department of Orthopaedic Surgery, Ningde Municipal Hospital Affiliated to Ningde Normal UniversityDepartment of Orthopaedic Surgery, Quanzhou Orthopedic-traumatological HospitalDepartment of Rehabilitation Medicine, Ningde Municipal Hospital Affiliated to Ningde Normal UniversityDepartment of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, Ningde Municipal Hospital Affiliated to Ningde Normal UniversityDepartment of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical UniversityAbstract Background and objective The efficacy of medial unicompartmental knee arthroplasty (UKA) in patients with intraoperatively identified patellofemoral osteoarthritis (PFOA) has been a subject of debate. This retrospective study aimed to investigate the early outcomes of UKA in patients with varying intraoperative PFOA conditions and to explore the relationship between the location of PFOA and the position of the prosthesis post-UKA. Our aim was to determine whether the presence of PFOA affects the short-term success of medial UKA. Methods This single-center, retrospective study included patients who underwent UKA by a same surgical team from March 2021 to November 2022. Patients were categorized into normal, medial, middle, and lateral groups based on the intraoperative PFOA findings. A total of 103 patients were analyzed, with data collected on demographics, intraoperative details, and pre- and postoperative laboratory and imaging data. Patellofemoral joint cartilage damage was assessed using the Outerbridge classification. Postoperative patellofemoral joint function was evaluated using the Lonner score, Oxford Knee Score (OKS), and visual analog scale (VAS) for pain. Results Significant improvements were observed in postoperative Lonner pain scores, Lonner functional scores, OKS, and VAS compared to preoperative values for all groups (P < 0.05). Medial and middle PFOA identified intraoperatively did not affect the short-term efficacy of medial UKA. Although lateral PFOA had some impact on UKA efficacy, patients still experienced significant postoperative pain relief and functional improvement. Differences in the tibial component posterior slope angle (TCPSA) were noted among the groups, particularly between the medial and lateral groups (P < 0.05). Conclusion Intraoperatively identified medial and middle PFOA do not influence the short-term efficacy of medial UKA. Lateral PFOA has some impact on UKA outcomes, yet patients demonstrate significant improvements in postoperative pain and function. Intraoperative PFOA should not be considered an absolute contraindication for medial UKA. The study’s follow-up duration was relatively short, necessitating further research on the mid- to long-term effectiveness of UKA in patients with combined PFOA.https://doi.org/10.1186/s12891-024-08270-8Patellofemoral osteoarthritisUnicomparment knee arthroplastyEfficacyProsthesis
spellingShingle Bei Li
Changyu Huang
Bingqian Zheng
Zida Huang
Xinyu Fang
Xiaoyong Wang
Wenming Zhang
Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
BMC Musculoskeletal Disorders
Patellofemoral osteoarthritis
Unicomparment knee arthroplasty
Efficacy
Prosthesis
title Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
title_full Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
title_fullStr Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
title_full_unstemmed Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
title_short Intraoperatively identified patellofemoral osteoarthritis: no significant impact on short-term outcomes of medial unicompartmental knee arthroplasty
title_sort intraoperatively identified patellofemoral osteoarthritis no significant impact on short term outcomes of medial unicompartmental knee arthroplasty
topic Patellofemoral osteoarthritis
Unicomparment knee arthroplasty
Efficacy
Prosthesis
url https://doi.org/10.1186/s12891-024-08270-8
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