術前膝蓋大腿関節症が人工膝単顆置換術の術後成績におよぼす影響

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  • Influence of Patellofemoral Joint Osteoarthritis for Clinical Results of Unicompartmental Knee Arthroplasty
  • ジュツゼン シツガイ ダイタイ カンセツショウ ガ ジンコウ シツタンカチカンジュツ ノ ジュツゴ セイセキ ニ オヨボス エイキョウ

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Objective: We performed unicompartmental knee arthroplasty (UKA) on patients with osteoarthritis (OA) of the knee and evaluated the clinical results. This study aimed to evaluate whether the severity of preoperative patellofemoral (PF) joint OA related to the final clinical results.<br>Methods: A total of 109 patients (125 affected knees) who had undergone UKA six months or more before the study were enrolled, included 14 males (15 affected knees) and 95 females (110 affected knees) with a mean age of 78.0 ± 5.3 years (range, 61-94 years). Clinical evaluation utilized the scoring system for OA of knees prepared by the Japanese Orthopaedic Association (JOA), and we investigated postoperative PF pain. We also performed radiological measurements using patient radiographs. Operations were performed by one surgeon, and intraoperative removal of osteophytes around the medial femoral condyle were undertaken. For statistical analysis we performed Mann-Whitney's U test and adopted a significance level of P < 0.05.<br>Results: The average JOA score improved significantly from 56.5 ± 11.0 preoperatively to 85.0 ± 5.6 postoperatively (P < 0.01). Postoperative PF pain was found in seven patients (8 affected knees) at the final evaluation. However, in these patients, the pain was less severe than it had been preoperatively. Postoperative radiological evaluation was generally favorable.<br>Conclusion: Clinical and radiological evaluation of UKA was generally favorable. However, we need to consider that postoperative PF-pain may persist in patients with severe PF-OA who experienced preoperative PF pain. We consider that it is important to assess patients' preoperative PF pain along with the severity of OA when considering proceeding to UKA.

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