Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthro
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(2020) 15:584
RESEARCH ARTICLE
Open Access
Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis Feifan Lu1, Yan Yan1, Weiguo Wang2, Qidong Zhang2*
and Wanshou Guo2*
Abstract Purpose: The argument that patellofemoral osteoarthritis (PFOA) is a contraindication to unicompartmental knee arthroplasty (UKA) remains to be resolved. The purpose of this study was to perform a meta-analysis to determine whether PFOA affects functional outcomes and survivorship after medial UKA. Methods: A literature search was performed in PubMed, Medline, Cochrane Library and Web of science to identify studies published in English (the last search was updated on June 1, 2020). The primary outcome measure was the Oxford Knee Score (OKS), whereas the secondary outcomes included range of motion (ROM) and the revision rate. Patients with patellofemoral joint narrowing or cartilage lesions as assessed intraoperatively or by radiography were assigned to the PFOA group. Results: A total of 8 studies involving 3504 patients and 3975 knees were included in this meta-analysis. No patients had a severe lateral patellar groove. The results showed that there was no significant difference in the OKS, revision rate and ROM between PFOA patients and patients without PFOA. Conclusions: No significant difference in functional outcomes and survivorship was found between patients with and without PFOA. Patients with PFOA assessed by radiographs or intraoperatively but without a lateral patellar groove should be considered candidates for medial UKA. Keywords: Patellofemoral osteoarthritis, UKA, Meta-analysis
Introduction Unicompartmental knee arthroplasty (UKA) is an effective method for the treatment of severe knee osteoarthritis and has received increasing attention. UKA can effectively relieve pain and improve function by surface replacement of the affected compartment and has the advantages of minimal trauma and a quick recovery. The * Correspondence: [email protected]; [email protected] 2 Department of Orthopedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, Peking Union Medical School, China-Japan Friendship Hospital, Beijing 100029, China Full list of author information is available at the end of the article
long-term and medium-term functional results are satisfactory [1–3]. However, the contraindications of UKA are still controversial. Kozinn and Scott [4] suggested in 1989 that exposed bone in the patellofemoral joint should be regarded as a contraindication to UKA. In contrast, Goodfellow et al. [5] suggested that these contraindications can be ignored for mobile-bearing UKA. In anteromedial osteoarthritis, patellofemoral osteoarthritis (PFOA) is not a contraindication to UKA. In 2007, Beard et al. [5–7] proposed that PFOA should not be considered a contraindication to UKA as long as no groove is present in the lateral patella. Some recent studies suggest that the
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