Department of Orthopedic Surgery, Cangzhou Hospital of Integrated TCM-WM, Cangzhou, P.R. China.
Department of Ultrasound, the Third Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
Medicine (Baltimore). 2022 Nov 11;101(45):e31409. doi: 10.1097/MD.0000000000031409.
Unicompartmental knee arthroplasty (UKA) is an ideal surgical approach in treatment of end-stage knee osteoarthritis (KOA), however, indications of UKA have been controversial, and the radiographic and symptomatic patellofemoral osteoarthritis (PFOA) are often considered as a contraindication of medial UKA. 337 fixed bearing UKAs were retrospectively recruited in our joint center between January 1, 2011 and June 30, 2020. There were 105 patients accompanied by PFOA and 232 patients have normal PF joint. International Cartilage Repair Society (ICRS) system was introduced to quantify the degeneration degree of PF joint. Oxford Knee Score (OKS), Forgotten Joint Score (FJS), Kellgren-Lawrence (K-L) classifying system and visual analogue scale (VAS) were adopted to evaluate outcomes between with and without PFOA. There was no significant difference of age, BMI, gender, OKS, FJS and other variables between PFOA and Non-PFOA group. After more than 5 years follow-up, UKA patients with or without PFOA could all achieve a satisfactory improvement of OKS, VAS and FJS score. ROM of the replaced knee increased from preoperative 110° to 130°. 74.3% (78/105) and 75.0% (174/232) patients have no change of K-L grade in PFOA and Non-PFOA group, OKS, FJS, VAS score and ROM were also comparable in all patients and no significant outcomes difference were found between two group. The presence of patellofemoral joint osteoarthritis and anterior knee pain should not be considered to be contraindications to medial fixed-bearing UKA.
单间室膝关节置换术（UKA）是治疗膝关节骨关节炎（KOA）终末期的理想手术方法，然而，UKA 的适应证一直存在争议，髌股关节（PFOA）的放射学和症状性骨关节炎通常被认为是内侧 UKA 的禁忌证。2011 年 1 月 1 日至 2020 年 6 月 30 日，我们的关节中心回顾性招募了 337 例固定衬垫 UKA。其中 105 例伴有 PFOA，232 例 PF 关节正常。采用国际软骨修复协会（ICRS）系统量化 PF 关节退变程度。采用牛津膝关节评分（OKS）、遗忘关节评分（FJS）、Kellgren-Lawrence（K-L）分级系统和视觉模拟评分（VAS）评估有无 PFOA 患者的疗效。两组间年龄、BMI、性别、OKS、FJS 等变量无统计学差异。随访 5 年以上，有无 PFOA 的 UKA 患者均可获得满意的 OKS、VAS 和 FJS 评分改善。置换膝关节的 ROM 从术前的 110°增加到 130°。74.3%（78/105）和 75.0%（174/232）的 PFOA 和非 PFOA 组患者 K-L 分级无变化，OKS、FJS、VAS 评分和 ROM 在所有患者中也相似，两组间无显著疗效差异。髌股关节骨关节炎和膝关节前痛的存在不应被视为内侧固定衬垫 UKA 的禁忌证。
