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Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival?
MedLine Citation:
PMID:  21902142     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
One contested contraindication to medial unicompartmental knee arthroplasty (UKA) has been status of the patellofemoral joint. Surgeons have avoided UKA when the patellofemoral joint has radiographic evidence of arthritic changes. However, recent studies advocate ignoring patellofemoral joint status when considering UKA. The purpose of this study was to compare the failure rate of mobile-bearing, medial UKA in patients with and without preoperative radiographic evidence of patellofemoral joint degeneration. Preoperative radiographs from a random selection of 503 patients (638 knees) treated with UKA for anteromedial osteoarthritis were assessed by an observer blinded to clinical outcome. The patellofemoral joint was graded using the modified Altman classification from 0 to 3 with 0 being no evidence of changes and 3 being severe, and identified 396 grade 0, 168 grade 1, 65 grade 2, and 9 grade 3 knees. At 1- to 7-year follow-up, there have been 17 revisions for overall survivorship of 97.3%. Kaplan-Meier analysis predicted 97.9% survival in knees with patellofemoral joint disease and 93.8% survival in knees without patellofemoral joint disease at 70 months (P=.1). Failure requiring revision occurred in 3.5% (14/396) of grade 0 knees, 1.2% (2/168) of grade 1, 1.5% (1/65) of grade 2, and 0% (0/9) of grade 3. No survival difference was noted between knees with medial or lateral patellofemoral joint disease (P=.1). No knees were revised for progression of disease in the patellofemoral joint or anterior knee pain. In light of this investigation and the work of others, preoperative radiographic changes in the patellofemoral joint can be safely ignored when considering patients for medial UKA without compromising survivorship.
Authors:
Keith R Berend; Adolph V Lombardi; Michael J Morris; Jason M Hurst; Joseph J Kavolus
Publication Detail:
Type:  Journal Article     Date:  2011-09-09
Journal Detail:
Title:  Orthopedics     Volume:  34     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2011  
Date Detail:
Created Date:  2011-09-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e494-6     Citation Subset:  IM    
Copyright Information:
Copyright 2011, SLACK Incorporated.
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