Research progress about influence of patellofemoral osteoarthritis on effectiveness of unicompartmental knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Yu ¹ , YUE Jiaji ² ,  YANG Chunxi ¹

1. Department of Orthopaedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P.R.China;
2. Department of Sports Medicine and Joint Surgery, the First Hospital of China Medical University, Shenyang Liaoning, 110000, P.R.China;

Corresponding author：

YANG Chunxi, Email: chunxi_yang@163.com

Keywords：

Unicompartmental knee arthroplasty; patellofemoral osteoarthritis; clinical outcome

DOI：

10.7507/1002-1892.201806011

Video：

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Objective To summarize the current research progress about influence of patellofemoral osteoarthritis on clinical outcome of unicompartmental knee arthroplasty (UKA). Methods The recent related literature was extensively reviewed and summarized, including pros and cons to regard the patellofemoral osteoarthritis as the contraindication. Results Previous studies regarded patellofemoral osteoarthritis as the contraindication of UKA. Most of current researches show that the damage to the articular cartilage of the patellofemoral joint to the extent of full-thickness cartilage loss has no influence on outcome of UKA. There is no correlation between preoperative anterior knee pain or medial patellofemoral joint degeneration and the clinical outcome. However, lateral subluxation of the patella has an adverse impact on postoperative curative effect. Degeneration of the lateral patellofemoral joint may be a risk factor of the outcome. Conclusion Patellofemoral osteoarthritis should not be the absolute contraindication of UKA. The effect of degeneration of the lateral patellofemoral joint is not clear at present, and still needs further studies in the future.

Citation： WANG Yu, YUE Jiaji, YANG Chunxi. Research progress about influence of patellofemoral osteoarthritis on effectiveness of unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(3): 377-381. doi: 10.7507/1002-1892.201806011 Copy

1.	Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg (Am), 1989, 71: 145-150.
2.	Stern SH, Becker MW, Insall JN. Unicondylar knee arthroplasty. An evaluation of selection criteria. Clin Orthop Relat Res, 1993, (286): 143-148.
3.	Sierra RJ, Kassel CA, Wetters NG, et al. Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk! J Arthroplasty, 2013, 28(8 Suppl): 128-132.
4.	Pandit H, Jenkins C, Gill HS, et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J Bone Joint Surg (Br), 2011, 93(5): 622-628.
5.	何川, 冯建民, 刘志宏, 等. 髌股关节退变对 Oxford 内侧单髁置换疗效的影响. 中华关节外科杂志(电子版), 2013, 7(4): 459-463.
6.	Parmaksizoğlu AS, Kabukçuoğlu Y, Ozkaya U, et al. Short-term results of the Oxford phase 3 unicompartmental knee arthroplasty for medial arthritis. Acta Orthop Traumatol Turc, 2010, 44(2): 135-142.
7.	Beard DJ, Pandit H, Gill HS, et al. The influence of the presence and severity of pre-existing patellofemoral degenerative changes on the outcome of the Oxford medial unicompartmental knee replacement. J Bone Joint Surg (Br), 2007, 89(12): 1597-1601.
8.	Knutson K, Lewold S, Robertsson O, et al. The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992. Acta Orthop Scand, 1994, 65(4): 375-386.
9.	Munk S, Odgaard A, Madsen F, et al. Preoperative lateral subluxation of the patella is a predictor of poor early outcome of Oxford phase-Ⅲ medial unicompartmental knee arthroplasty. Acta Orthop, 2011, 82(5): 582-588.
10.	Beard DJ, Pandit H, Ostlere S, et al. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg (Br), 2007, 89(12): 1602-1607.
11.	Hamilton TW, Pandit HG, Maurer DG, et al. Anterior knee pain and evidence of osteoarthritis of the patellofemoral joint should not be considered contraindications to mobile-bearing unicompartmental knee arthroplasty: a 15-year follow-up. Bone Joint J, 2017, 99-B(5): 632-639.
12.	Han I, Chang CB, Lee S, et al. Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. J Bone Joint Surg (Br), 2005, 87(8): 1081-1084.
13.	Berend KR, Lombardi AV Jr, Morris MJ, et al. Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival? Orthopedics, 2011, 34(9): e494-e496.
14.	Yue J, Ma X, Li Y, et al. Influence of bone marrow edema on medial unicompartmental knee arthroplasty among patients with patellofemoral osteoarthritis. J Knee Surg, 2017, 30(8): 816-821.
15.	Thein R, Zuiderbaan HA, Khamaisy S, et al. Medial unicondylar knee arthroplasty improves patellofemoral congruence: a possible mechanistic explanation for poor association between patellofemoral degeneration and clinical outcome. J Arthroplasty, 2015, 30(11): 1917-1922.
16.	张建兵, 申云龙, 杨延涛, 等. 髌股适合角正常值准确性的初步研究. 中国骨与关节损伤杂志, 2016, 31(2): 190-191.
17.	Emery IH, Meachim G. Surface morphology and topography of patello-femoral cartilage fibrillation in Liverpool necropsies. J Anat, 1973, 116(Pt 1): 103-120.
18.	Arøen A, Løken S, Heir S, et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med, 2004, 32(1): 211-215.
19.	Berger RA, Meneghini RM, Sheinkop MB, et al. The progression of patellofemoral arthrosis after medial unicompartmental replacement-results at 11 to 15 years. Clin Orthop Relat Res, 2004, 428: 92-99.
20.	Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.
21.	Cicuttini FM, Baker J, Hart DJ, et al. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthritis Cartilage, 1996, 4(2): 143-147.
22.	Pongcharoen B, Reutiwarangkoon C. The comparison of anterior knee pain in severe and non severe arthritis of the lateral facet of the patella following a mobile bearing unicompartmental knee arthroplasty. Springerplus, 2016, 5: 202.
23.	何川, 燕宇飞, 冯建民, 等. 外侧髌股关节退变对膝关节内侧单髁置换疗效的影响. 生物骨科材料与临床研究, 2015, 12(2): 29-32.
24.	马童, 蔡珉巍, 薛华明, 等. 髌股关节退变对膝关节单髁置换术疗效影响的研究. 中华外科杂志, 2013, 51(11): 1010-1015.
25.	Konan S, Haddad FS. Does location of patellofemoral chondral lesion influence outcome after Oxford medial compartmental knee arthroplasty? Bone Joint J, 2016, 99-B(10 Supple B): 11-15.
26.	胥伯勇, 纪保超, 郭文涛, 等. 术前髌股关节退变对 Oxford 膝关节内侧单髁置换术疗效的影响. 中华外科杂志, 2017, 55(6): 416-422.
27.	Lisowski LA, van den Bekerom MP, Pilot P, et al. Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 277-284.
28.	He JY, Jiang LS, Dai LY. Is patellar resurfacing superior than nonresurfacing in total knee arthroplasty? A meta-analysis of randomized trials. Knee, 2011, 18(3): 137-144.
29.	Breeman S, Campbell M, Dakin H, et al. Patellar resurfacing in total knee replacement: five-year clinical and economic results of a large randomized controlled trial. J Bone Joint Surg (Am), 2011, 93(16): 1473-1481.
30.	Cuthbert R, Tibrewal S, Tibrewal SB. Patellofemoral arthroplasty: Current concepts. J Clin Orthop Trauma, 2018, 9(1): 24-28.
31.	Park BH, Leffler J, Franz A, et al. Kinematics of monoblock bicompartmental knee arthroplasty during weight-bearing activities. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6): 1756-1762.
32.	郭盛杰, 杨德金, 邵宏翊, 等. 组配式髌股关节置换联合内侧单髁置换治疗膝关节双间室骨关节炎的早期临床疗效. 骨科临床与研究杂志, 2017, 2(4): 197-202.
33.	Du H, Tang H, Gu JM, et al. Patient satisfaction after posterior-stabilized total knee arthroplasty: a functional specific analysis. Knee, 2014, 21(4): 866-870.
34.	W-Dahl A, Robertsson O, Lidgren L. Surgery for knee osteoarthritis in younger patients. Acta Orthop, 2010, 81(2): 161-164.
35.	Julin J, Jämsen E, Puolakka T, et al. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register. Acta Orthop, 2010, 81(4): 413-419.
36.	Biazzo A, Silvestrini F, Manzotti A, Confalonieri N. Bicompartmental (uni plus patellofemoral) versus total knee arthroplasty: a match-paired study. Musculoskelet Surg, 2018. https://doi.org/10.1007/s12306-018-0540-1.
37.	Kooner S, Johal H, Clark M. Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis. Arthroplast Today, 2017, 3(4): 309-314.

1. Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg (Am), 1989, 71: 145-150.
2. Stern SH, Becker MW, Insall JN. Unicondylar knee arthroplasty. An evaluation of selection criteria. Clin Orthop Relat Res, 1993, (286): 143-148.
3. Sierra RJ, Kassel CA, Wetters NG, et al. Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk! J Arthroplasty, 2013, 28(8 Suppl): 128-132.
4. Pandit H, Jenkins C, Gill HS, et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J Bone Joint Surg (Br), 2011, 93(5): 622-628.
5. 何川, 冯建民, 刘志宏, 等. 髌股关节退变对 Oxford 内侧单髁置换疗效的影响. 中华关节外科杂志(电子版), 2013, 7(4): 459-463.
6. Parmaksizoğlu AS, Kabukçuoğlu Y, Ozkaya U, et al. Short-term results of the Oxford phase 3 unicompartmental knee arthroplasty for medial arthritis. Acta Orthop Traumatol Turc, 2010, 44(2): 135-142.
7. Beard DJ, Pandit H, Gill HS, et al. The influence of the presence and severity of pre-existing patellofemoral degenerative changes on the outcome of the Oxford medial unicompartmental knee replacement. J Bone Joint Surg (Br), 2007, 89(12): 1597-1601.
8. Knutson K, Lewold S, Robertsson O, et al. The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992. Acta Orthop Scand, 1994, 65(4): 375-386.
9. Munk S, Odgaard A, Madsen F, et al. Preoperative lateral subluxation of the patella is a predictor of poor early outcome of Oxford phase-Ⅲ medial unicompartmental knee arthroplasty. Acta Orthop, 2011, 82(5): 582-588.
10. Beard DJ, Pandit H, Ostlere S, et al. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg (Br), 2007, 89(12): 1602-1607.
11. Hamilton TW, Pandit HG, Maurer DG, et al. Anterior knee pain and evidence of osteoarthritis of the patellofemoral joint should not be considered contraindications to mobile-bearing unicompartmental knee arthroplasty: a 15-year follow-up. Bone Joint J, 2017, 99-B(5): 632-639.
12. Han I, Chang CB, Lee S, et al. Correlation of the condition of the patellar articular cartilage and patellofemoral symptoms and function in osteoarthritic patients undergoing total knee arthroplasty. J Bone Joint Surg (Br), 2005, 87(8): 1081-1084.
13. Berend KR, Lombardi AV Jr, Morris MJ, et al. Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival? Orthopedics, 2011, 34(9): e494-e496.
14. Yue J, Ma X, Li Y, et al. Influence of bone marrow edema on medial unicompartmental knee arthroplasty among patients with patellofemoral osteoarthritis. J Knee Surg, 2017, 30(8): 816-821.
15. Thein R, Zuiderbaan HA, Khamaisy S, et al. Medial unicondylar knee arthroplasty improves patellofemoral congruence: a possible mechanistic explanation for poor association between patellofemoral degeneration and clinical outcome. J Arthroplasty, 2015, 30(11): 1917-1922.
16. 张建兵, 申云龙, 杨延涛, 等. 髌股适合角正常值准确性的初步研究. 中国骨与关节损伤杂志, 2016, 31(2): 190-191.
17. Emery IH, Meachim G. Surface morphology and topography of patello-femoral cartilage fibrillation in Liverpool necropsies. J Anat, 1973, 116(Pt 1): 103-120.
18. Arøen A, Løken S, Heir S, et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med, 2004, 32(1): 211-215.
19. Berger RA, Meneghini RM, Sheinkop MB, et al. The progression of patellofemoral arthrosis after medial unicompartmental replacement-results at 11 to 15 years. Clin Orthop Relat Res, 2004, 428: 92-99.
20. Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.
21. Cicuttini FM, Baker J, Hart DJ, et al. Association of pain with radiological changes in different compartments and views of the knee joint. Osteoarthritis Cartilage, 1996, 4(2): 143-147.
22. Pongcharoen B, Reutiwarangkoon C. The comparison of anterior knee pain in severe and non severe arthritis of the lateral facet of the patella following a mobile bearing unicompartmental knee arthroplasty. Springerplus, 2016, 5: 202.
23. 何川, 燕宇飞, 冯建民, 等. 外侧髌股关节退变对膝关节内侧单髁置换疗效的影响. 生物骨科材料与临床研究, 2015, 12(2): 29-32.
24. 马童, 蔡珉巍, 薛华明, 等. 髌股关节退变对膝关节单髁置换术疗效影响的研究. 中华外科杂志, 2013, 51(11): 1010-1015.
25. Konan S, Haddad FS. Does location of patellofemoral chondral lesion influence outcome after Oxford medial compartmental knee arthroplasty? Bone Joint J, 2016, 99-B(10 Supple B): 11-15.
26. 胥伯勇, 纪保超, 郭文涛, 等. 术前髌股关节退变对 Oxford 膝关节内侧单髁置换术疗效的影响. 中华外科杂志, 2017, 55(6): 416-422.
27. Lisowski LA, van den Bekerom MP, Pilot P, et al. Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure. Knee Surg Sports Traumatol Arthrosc, 2011, 19(2): 277-284.
28. He JY, Jiang LS, Dai LY. Is patellar resurfacing superior than nonresurfacing in total knee arthroplasty? A meta-analysis of randomized trials. Knee, 2011, 18(3): 137-144.
29. Breeman S, Campbell M, Dakin H, et al. Patellar resurfacing in total knee replacement: five-year clinical and economic results of a large randomized controlled trial. J Bone Joint Surg (Am), 2011, 93(16): 1473-1481.
30. Cuthbert R, Tibrewal S, Tibrewal SB. Patellofemoral arthroplasty: Current concepts. J Clin Orthop Trauma, 2018, 9(1): 24-28.
31. Park BH, Leffler J, Franz A, et al. Kinematics of monoblock bicompartmental knee arthroplasty during weight-bearing activities. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6): 1756-1762.
32. 郭盛杰, 杨德金, 邵宏翊, 等. 组配式髌股关节置换联合内侧单髁置换治疗膝关节双间室骨关节炎的早期临床疗效. 骨科临床与研究杂志, 2017, 2(4): 197-202.
33. Du H, Tang H, Gu JM, et al. Patient satisfaction after posterior-stabilized total knee arthroplasty: a functional specific analysis. Knee, 2014, 21(4): 866-870.
34. W-Dahl A, Robertsson O, Lidgren L. Surgery for knee osteoarthritis in younger patients. Acta Orthop, 2010, 81(2): 161-164.
35. Julin J, Jämsen E, Puolakka T, et al. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register. Acta Orthop, 2010, 81(4): 413-419.
36. Biazzo A, Silvestrini F, Manzotti A, Confalonieri N. Bicompartmental (uni plus patellofemoral) versus total knee arthroplasty: a match-paired study. Musculoskelet Surg, 2018. https://doi.org/10.1007/s12306-018-0540-1.
37. Kooner S, Johal H, Clark M. Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis. Arthroplast Today, 2017, 3(4): 309-314.

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