No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritis.

PURPOSE: The purpose of the present study was to compare functional outcomes of medial unicompartmental knee arthroplasty (UKA) in patients with patellofemoral osteoarthritis (PF OA) and those without PF OA and to evaluate the effect of PF OA on functional outcomes after UKA. METHODS: The outcomes of 48 knees in patients without PF OA who underwent medial UKA (non-PF OA group) were compared to the outcomes of 57 knees in patients with PF OA [Kellgren-Lawrence (K-L) grade ≤ 2] who underwent medial UKA (PF OA group) with a median follow-up of 5.4 years (range 3.1-10.2 years). Clinical outcomes including anterior knee pain, HSS scores, radiological parameters, and the progression of patellofemoral osteoarthritis were compared, and their effects on functional outcomes were evaluated at the final follow-up visits. RESULTS: At final follow-up visits, no significant inter-group difference was found in terms of anterior knee pain (1.9 vs. 1.9 in non-PF OA and PF OA groups, respectively), HSS score, or range of motion. Preoperative anterior knee pain and patellofemoral joint degeneration were found to be unrelated to poor outcome in patients that underwent medial UKA. Furthermore, no correlation was found between any functional outcome variable and chondral lesion pattern. CONCLUSIONS: The result of UKA for medial unicompartmental knee osteoarthritis was excellent regardless of PF OA (K-L grade ≤ 2). Hence, the patients with medial unicompartmental OA combined with a moderate degree of anterior knee pain or patellofemoral arthritis should be viewed as appropriate candidates for medial UKA. LEVEL OF EVIDENCE: III.

A randomized controlled clinical and radiological trial about outcomes of navigation-assisted TKA compared to conventional TKA: long-term follow-up.

PURPOSE: Well balanced knees with good alignment are essential for a well-functioning TKA with long survival of its implants. This prospective randomized study comparing navigation-assisted TKA and conventional TKA reported the clinical and radiological outcomes at a follow-up of 9 years. The purpose of this study was to compare the clinical and radiological outcomes for patients who underwent navigation-assisted TKA or conventional TKA after long-term follow-up. METHODS: A total of 80 patients (88 knees) were available for physical and radiological examination 9 years after TKA. Clinical outcomes were evaluated using HSS, WOMAC, and KS function and pain scores. And radiological outcomes of the component loosening and its survivorship during 9-year follow-up were also evaluated. RESULTS: There were no significant differences in the field of clinical outcomes between the two groups. In terms of radiological outcomes, the navigation group had fewer alignment outliers (7.3 vs 20 %, p = 0.006). Although the clinical outcomes showed no differences between the two groups, the survival rate was slightly better in the navigation group than in the conventional group without statistical significance (best-case scenario 100 vs 95.3 %, n.s., worst-case scenario 95.6 vs 88.4 %, n.s.). CONCLUSION: Navigation-assisted TKA produced better alignment outcomes and better survival rates than conventional instruments although some of the differences were not statistically significant. LEVEL OF EVIDENCE: I.

Single-Stage Corrective Osteotomies for Multiple Angular Deformities Around the Knee Joint with Patellar Instability in a Patient with Multiple Epiphyseal Dysplasia: A Case Report.

CASE: It is rare to find a case report on combined recurvatum and valgus deformity of the knee with associated patellar instability due to a depressed lateral tibial plateau in a young adult with multiple epiphyseal dysplasia. We treated such a patient with single-stage osseous and soft-tissue procedures and achieved a stable, well-aligned, pain-free, and mobile joint. CONCLUSION: Patellar instability with genu recurvatum and genu valgum leading to reduced range of motion of the knee in multiple epiphyseal dysplasia shows mechanical and functional improvement following single-stage surgical intervention, thereby improving quality of life.