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Introduction
Osteoarthritis isolated to one compartment of
the knee is relatively common. Unicompart
mental knee arthroplasty (UKA) is a viable
treatment option in these patients, providing
durable pain relief and functional improvement
[3, 4, 23, 27, 35]. Advantages of UKA over
total knee arthroplasty (TKA) include less pain,
more rapid functional recovery, and the
retention of both cruciate ligaments leading to
more normal gait patterns [1, 13, 34, 38].
Because of the advantages noted above, it is
desirable to extend the indications of UKA to
include patients with disease affecting the
patellofemoral joint. Although some authors
havedescribedpatellofemoraljointinvolvement
as a contraindication to UKA [21, 36] several
recent studies have demonstrated no adverse
effects of patellofemoral articular cartilage loss
on outcomes, particularly when the medial
facet is involved [5, 14, 19, 30]. However,
some authors have suggested that lateral facet
involvement portends worse outcomes,
particularly in cases on lateral patellar grooving
or bone loss [5, 6].
Patellofemoral degenerative change has been
shown to be a source of anterior knee pain in
patients with normal tibiofemoral joints [11].
Because the lateral patellar facet is the most
frequentlocationofpatellofemoralosteoarthritis
[18], several authors have reported partial
lateral patellar facetectomy as a treatment
option. Reported results have generally been
good, with improved pain and function at both
short- and medium-term follow-up [25, 31,
39]. The majority of treatment failures were
related to related to the development and
progression of tibiofemoral osteoarthritis [25,
31, 39].
We hypothesize that simultaneous lateral UKA
and lateral patellar facetectomy provides
durable pain relief and functional improvement
in a patient population with degenerative
disease of lateral tibiofemoral compartment
and the lateral patellofemoral joint.
Materials and Methods
Patient Population
Between January 2004 and May 2008, one
hundred and thirty-two UKAs were performed
at our institution, including 77 medial UKAs
and 55 lateral UKAs. Patients with less than
3 years follow-up were excluded. Thirteen
UKAs (one medial and twelve lateral) were
performed in association with partial lateral
patellar facetectomy in thirteen female patients
with degenerative changes in one tibiofemoral
Is patellofemoral
osteoarthritis a problem
for unicompartmental knee
arthroplasty?
E. Gancel, R.A. Magnussen, F. Trouillet,
S. Lustig, E. Servien, P. Neyret