Li Bei, Huang Changyu, Zheng Bingqian, Huang Zida, Fang Xinyu, Wang Xiaoyong, Zhang Wenming
Department of Orthopaedic Surgery, Ningde Municipal Hospital Affiliated to Ningde Normal University, NO. 13 Mindong East Road, Jiaocheng District, Ningde, 352000, China.
Department of Orthopaedic Surgery, The First Affiliated Hospital, Fujian Medical University, No.20, Chazhong road, Fuzhou, 350005, China.
BMC Musculoskelet Disord. 2025 Jan 8;26(1):28. doi: 10.1186/s12891-024-08270-8.
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.
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.
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).
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.
术中确诊为髌股关节炎（PFOA）的患者行内侧单髁膝关节置换术（UKA）的疗效一直存在争议。本回顾性研究旨在调查不同术中PFOA情况的患者行UKA的早期疗效，并探讨PFOA的位置与UKA术后假体位置之间的关系。我们的目的是确定PFOA的存在是否会影响内侧UKA的短期成功率。
本单中心回顾性研究纳入了2021年3月至2022年11月由同一手术团队进行UKA的患者。根据术中PFOA的检查结果，将患者分为正常组、内侧组、中间组和外侧组。共分析了103例患者，收集了人口统计学、术中细节以及术前和术后实验室及影像学数据。采用Outerbridge分类法评估髌股关节软骨损伤情况。使用Lonner评分、牛津膝关节评分（OKS）和疼痛视觉模拟量表（VAS）评估术后髌股关节功能。
与术前相比，所有组术后Lonner疼痛评分、Lonner功能评分、OKS和VAS均有显著改善（P < 0.05）。术中确诊的内侧和中间PFOA不影响内侧UKA的短期疗效。虽然外侧PFOA对UKA疗效有一定影响，但患者术后仍有明显的疼痛缓解和功能改善。各组间胫骨假体后倾角度（TCPSA）存在差异，尤其是内侧组和外侧组之间（P < 0.05）。
术中确诊的内侧和中间PFOA不影响内侧UKA的短期疗效。外侧PFOA对UKA结果有一定影响，但患者术后疼痛和功能有显著改善。术中PFOA不应被视为内侧UKA的绝对禁忌证。本研究的随访时间相对较短,有必要进一步研究UKA在合并PFOA患者中的中长期疗效。
