Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment

The Knee
Hemant PanditD W Murray

Abstract

It is recommended that in medial compartment osteoarthritis (OA) unicompartmental knee replacement (UKR) should not be undertaken unless there is bone on bone. This recommendation is not evidence based and it is important to know if it is correct as there are many patients with pain and partial thickness cartilage loss (PTCL) who could potentially benefit from UKR. The aim of this study was to determine if the recommendation is valid. From our database of over 1000 patients treated with the Oxford UKR, we identified 29 with medial OA that had PTCL, confirmed at operation, but otherwise satisfied the recommended indications. This group was matched with 29 knees that had bone exposed (BE) on both sides of the medial compartment and 29 knees that had bone loss (BL) on both sides of the medial compartment. There was no significant difference in the demographics or preoperative scores between the three groups. At a mean follow up of 2 years (range 1-6) the Oxford Knee Score (OKS) of the PTCL group (mean 36 SD 10) was significantly (p < 0.001) worse than the OKS of either the bone exposed group (mean 43 SD 4) or the bone loss group (mean 43 SD 5). 21% of those with PTCL did not benefit substantially from the operation (increase in OK...Continue Reading

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Citations

Oct 18, 2011·Skeletal Radiology·Nawfal Al-HadithyYegappan Kalairajah
Nov 20, 2013·Clinical Orthopaedics and Related Research·Tuukka NiinimäkiVille Remes
Oct 3, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·L D JonesD J Beard
Oct 3, 2015·The Bone & Joint Journal·D W MurrayH Pandit
Apr 20, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Wenzel WaldsteinFriedrich Boettner
Apr 16, 2016·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·John A SzivekKarl H Wenger
May 11, 2016·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·Francesco MancusoHemant Pandit
May 23, 2016·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Wenzel WaldsteinReinhard Windhager
Apr 10, 2018·The Bone & Joint Journal·D W Murray, R W Parkinson
Sep 3, 2020·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·Anurag MittalTae Kyun Kim
Sep 15, 2015·Expert Review of Medical Devices·Samik BanerjeeMichael A Mont
Aug 28, 2012·Clinical Orthopaedics and Related Research·Gregory G PolkowskiRobert L Barrack
Jan 24, 2020·Archives of Orthopaedic and Trauma Surgery·Iben Rønne JessingAnders Troelsen
Mar 8, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Lars-Rene TueckingM Ettinger
Oct 8, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Johannes HolzMartin Lind
Apr 9, 2021·EFORT Open Reviews·Daniel J McCormackSteven P Godsiff
Feb 2, 2011·The Journal of Bone and Joint Surgery. British Volume·H PanditD W Murray
Aug 31, 2021·Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology·Takaaki HiranakaToshifumi Ozaki

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