The implications of damage to the lateral femoral condyle on medial unicompartmental knee replacement
| Autor: | Hemant Pandit, C. A. F. Dodd, D W Murray, N. Bottomley, B. J. L. Kendrick, Andrew Price, R Rout, Harinderjit Gill |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Cartilage Articular Male Reoperation medicine.medical_specialty Knee Joint medicine.medical_treatment Osteoarthritis Condyle Humans Medicine Orthopedics and Sports Medicine Prospective Studies Arthroplasty Replacement Knee Unicompartmental knee arthroplasty Ulcer Aged Aged 80 and over Varus deformity Subluxation business.industry Contraindications Cartilage Middle Aged Osteoarthritis Knee medicine.disease Surgery Radiography Treatment Outcome medicine.anatomical_structure Orthopedic surgery Female business Cartilage Diseases Oxford knee score Follow-Up Studies |
| Popis: | With medial unicompartmental osteoarthritis (OA) there is occasionally a full-thickness ulcer of the cartilage on the medial side of the lateral femoral condyle. It is not clear whether this should be considered a contraindication to unicompartmental knee replacement (UKR). The aim of this study was to determine why these ulcers occur, and whether they compromise the outcome of UKR. Case studies of knees with medial OA suggest that cartilage lesions on the medial side of the lateral condyle are caused by impingement on the lateral tibial spine as a result of the varus deformity and tibial subluxation. Following UKR the varus and the subluxation are corrected, so that impingement is prevented and the damaged part of the lateral femoral condyle is not transmitting load. An illustrative case report is presented. Out of 769 knees with OA of the medial compartment treated with the Oxford UKR, 59 (7.7%) had partial-thickness cartilage loss and 20 (2.6%) had a full-thickness cartilage deficit on the medial side of the lateral condyle. The mean Oxford Knee Score (OKS) at the last follow-up at a mean of four years was 41.9 (13 to 48) in those with partial-thickness cartilage loss and 41.0 (20 to 48) in those with full-thickness loss. In those with normal or superficially damaged cartilage the mean was 39.5 (5 to 48) and 39.7 (8 to 48), respectively. There were no statistically significant differences between the pre-operative OKS, the final review OKS or of change in the score in the various groups. We conclude that in medial compartment OA, damage to the medial side of the lateral femoral condyle is caused by impingement on the tibial spine and should not be considered a contraindication to an Oxford UKR, even if there is extensive full-thickness ulceration of the cartilage. |
| Databáze: | OpenAIRE |
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