A Clinical Study Of The Influences Of Unicompartmental Knee Replacement On Patellofemoral Joint Situation

Background and PurposeUnicompartmental knee arthroplasty(UKA) is a surgical for single compartment osteoarthritis artificial(mainly medial compartment). For osteoarthritis patients with lesions confined to one side compartment, results are more precise. Compared to total knee arthroplasty(TKA), UKA has many advantages, such as: surgical trauma, less bleeding, rapid postoperative recovery, preserves more biological function of the human body, postoperative feel are better. However, at early stages since less reasonable choose surgery patients, design and technical issues of surgery joint prosthesis, postoperative complications are much more than TKA, limiting its development and application. For patients in Asia, retain more function of the postoperative knee flexion, bring a lot of immediate convenience in everyday life. This makes UKA have better market demand and development space in Asia. Currently awareness of single compartment osteoarthritis has been greatly improved, the corresponding UKA implants, surgical instruments, surgical technique also has made great progress compared to earlier years, indications for surgery are also relaxed, but for the single compartment knee osteoarthritis patients with patellofemoral joint symptoms, there are still a lot of controversy about the choice of UKA or TKA. Currently research reports about patellofemoral situation before and after UKA surgery are still less. The purpose of this study was to investigate the situation changes in the patellofemoral joint of knee medial single compartment osteoarthritis(Osteoarthritis, OA) patients with patellofemoral symptoms, analyzes factors affecting UKA therapeutic effect; explore the feasibility of use UKA to treat medial compartment OA with patellofemoral joint degeneration. Materials and MethodsThis study was a retrospective analysis of our hospital 25 cases(33 knees) who had medial compartment knee OA with patellofemoral symptoms. All patients were given treatment of UKA. Taken weight-bearing X-ray measurement before and after surgery,measured and compared tibiofemoral angle changes. Intraoperative findings of patellofemoral joint state were using Outerbridge classification system to grade, patellofemoral pain and functional changesbefore and after surgery adopted lonner patellofemoral scoring system for evaluation. Respectively, after 3 months, 6 months, 1 year were followed up prospectively analysis the patient's condition changes of the patellofemoral joint: changes in pain and function scores. Results and ConclusionPreoperative patellofemoral total scores of 33 knees were poor, but 1 year later the score increased to 11 cases excellent(33%), 14 cases of good(41%), 8 cases in general(26%), and none score was poor. Final results showed that whether patellofemoral pain scores, or functional scores, or total scores are satisfied. This result indicates that, in one year's time after UKA surgery, existing patellofemoral symptoms were no worse than that of before but were eased, so we believe that the use of UKA for treating medial compartment OA patients with patellofemoral degeneration or patellofemoral clinical manifestations is feasible, at least the effect is satisfactory in the short term.