Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Okayama University (No. 1857). Consent to participate: Written informed consent was obtained from all patients. Consent to publish: Informed consent was obtained from all individual participants included in the study. 5. J ISAKOS. 2024 Aug;9(4):549-556. doi: 10.1016/j.jisako.2024.04.003. Epub 2024 Apr 6. Associated patellofemoral osteoarthritis is not a contraindication for unicompartmental knee replacement. Report of one hundred ten prostheses with an average 6-year follow-up. Gaggiotti S(1), Gaggiotti S(2), Ringa JC(2), Gaggiotti G(2). Author information: (1)Orthopedics and Traumatology Center Santa Fe & Rafaela, Argentina; Orthopedic Surgery Service Sanatorio Mayo, Santa Fe, Argentina. Electronic address: stefanogaggiotti72@gmail.com. (2)Orthopedics and Traumatology Center Santa Fe & Rafaela, Argentina; Orthopedic Surgery Service Sanatorio Mayo, Santa Fe, Argentina. INTRODUCTION: Associated patellofemoral joint osteoarthritis (APFJ-OA) has typically been considered a contraindication for unicompartmental knee arthroplasty (UKA) in the treatment of femorotibial joint osteoarthritis. However, this contraindication is being challenged. The aim of this study was to assess clinical and functional outcomes, complications, and implant survival in medial or lateral UKA, regardless of clinical symptoms or radiographic signs of APFJ-OA. METHODS: This retrospective, comparative study included patients treated with medial or lateral UKA regardless of preoperative symptoms or signs of APFJ-OA, with a minimum 2-year follow-up. Intraoperatively, knees were subdivided based on APFJ-OA grade, according to the Outerbridge classification. Clinical and functional outcomes were analyzed using the 2011 Knee Society Score (KSS) at the last follow-up control. APFJ-OA was treated systematically, in a tailored, stepwise fashion according to its severity. Complications and implant survival rates were evaluated. Two-sided paired T-test, ANOVA, and Kruskal-Wallis tests were used with a significance level of 5%. RESULTS: Finally, 110 UKAs were assessed 81 (73.6%) medial and 29 (26.4%) laterals. The average follow-up was 6 years (2-19.5). According to Outerbridge, 22 knees (20%) were in grade 2, 59 (53.6%) were in grade 3, and 29 (26.4%) were in grade 4. All three groups showed a statistically significant increase in KSS scores and range of motion. There were no significant differences in clinical KSS improvement and flexion contracture between Outerbridge groups (average 35.7 and -4.9, respectively). Group 3 showed statistically significant improvement in functional KSS when compared to group 2 (68.8 vs 61.2). In maximum flexion, groups 3 and 4 did significantly better than group 2 (20° vs 15°). Three prostheses (2.7%) needed revision after 7, 8.6, and 12 years due to aseptic tibial loosening. Implant survival was 100% at 5 (64 of 64), 97% at 7 (30 of 31), 93% at 9 (14 of 15), and 89% at 12 years, respectively (8 of 9). CONCLUSION: Clinical and functional results, complications, and survival of medial or lateral UKA were not negatively affected by APFJ-OA assessed intraoperatively using the Outerbridge classification after an average follow-up of 6 years. We consider that APFJ-OA is not a contraindication for UKA when treated systematically according to its severity. LEVEL OF EVIDENCE: IV. Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jisako.2024.04.003