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© 2017 The British Editorial Society of Bone & Joint Surgery. Aims: It is not clear whether anterior knee pain and osteoarthritis (OA) of the patellofemoral joint (PFJ) are contraindications to medial unicompartmental knee arthroplasty (UKA). Our aim was to investigate the long-term outcome of a consecutive series of patients, some of whom had anterior knee pain and P FJ OA managed with UKA. Patients and Methods: We assessed the ten-year functional outcomes and 15-year implant survival of 805 knees (677 patients) following medial mobile-bearing UKA. The intra-operative status of the P FJ was documented and, with the exception of bone loss with grooving to the lateral side, neither the clinical or radiological state of the P FJ nor the presence of anterior knee pain were considered a contraindication. The impact of radiographic findings and anterior knee pain was studied in a subgroup of 100 knees (91 patients). Results: There was no relationship between functional outcomes, at a mean of ten years, or 15-year implant survival, and pre-operative anterior knee pain, or the presence or degree of cartilage loss documented intra-operatively at the medial patella or trochlea, or radiographic evidence of OA in the medial side of the PFJ. In 6% of cases there was full thickness cartilage loss on the lateral side of the patella. In these cases, the overall ten-year function and 15-year survival was similar to those without cartilage loss; however they had slightly more difficulty with descending stairs. Radiographic signs of OA seen in the lateral part of the P FJ were not associated with a definite compromise in functional outcome or implant survival. Conclusion: Severe damage to the lateral side of the P FJ with bone loss and grooving remains a contraindication to mobile-bearing UKA. Less severe damage to the lateral side of the P FJ and damage to the medial side, however severe, does not compromise the overall function or survival, so should not be considered to be a contraindication. However, if a patient does have full thickness cartilage loss on the lateral side of the P FJ they may have a slight compromise in their ability to descend stairs. Pre-operative anterior knee pain also does not compromise the functional outcome or survival and should not be considered to be a contraindication.

Original publication

DOI

10.1302/0301-620X.99B5.BJJ-2016-0695.R2

Type

Journal article

Journal

Bone and Joint Journal

Publication Date

01/05/2017

Volume

99B

Pages

632 - 639