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Osteochondral lesions or necrosis of the
femoral condyle, and much less commonly of
the tibia, is a recognised indication for
surgery, as long as there is sufficient bone
stock to accommodate a prosthesis. These
should be differentiated from fatigue fractures,
which can be challenging in the early phase.
Serial imaging is useful in clarifying this
situation.
Meniscal calcifications or chondrocalcinosis of
the opposite compartment is not a contra-
indication [13]. Global wear, as seen in the
inflammatory arthritides, is generally accepted
as a firm contra-indication [23].
Post-traumatic deformities are contraindicated,
with the exception of isolated collapse of a
lateral tibial plateau fractures, wich results in
an intra-articular deformity [21, 36] (fig. 4).
Fig. 1: Typical medial femoro-tibial OA on AP and lateral standing views.
Fig. 2: Typical skyline view were patello-femoral joint is well aligned without cartilage wear.