Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty
Abstract. Background:. Patellofemoral joint (PFJ) degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty (UKA). More recently, some researchers have proposed that PFJ degeneration can be ignored in medial UKA, and others have proposed that this chang...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-07-01
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| Series: | Chinese Medical Journal |
| Online Access: | http://journals.lww.com/10.1097/CM9.0000000000002099 |
| _version_ | 1797786213505040384 |
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| author | Limin Wu Quan Chen Haibo Si Yuangang Wu Yi Zeng Mingyang Li Yuan Liu Bin Shen Ningning Wang |
| author_facet | Limin Wu Quan Chen Haibo Si Yuangang Wu Yi Zeng Mingyang Li Yuan Liu Bin Shen Ningning Wang |
| author_sort | Limin Wu |
| collection | DOAJ |
| description | Abstract. Background:. Patellofemoral joint (PFJ) degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty (UKA). More recently, some researchers have proposed that PFJ degeneration can be ignored in medial UKA, and others have proposed that this change should be reviewed in PFJ degenerative facets and severity. This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures (PROMs) and revision rates after medial UKA.
Methods:. Electronic databases (PubMed, Embase, Web of Science, etc.) were searched for studies assessing the influence of PFJ degeneration on medial UKA. A random-effects meta-analysis was conducted for the Oxford knee score (OKS), Knee society score (KSS), and revision rates and stratified by PFJ degenerative facets (medial/lateral/trochlear/unspecified), severe PFJ degeneration (bone exposed), and bearing type (mobile/fixed). Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic.
Results:. A total of 34 articles with 7007 knees (2267 with PFJ degeneration) were included (5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified). Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS, and only lateral facets significantly decreased the OKS (mean difference [MD] = −2.18, P < 0.01) and KSS (MD = −2.61, P < 0.01). The severity degree of PFJ degeneration had no additional adverse effect on the OKS, KSS, or revision rates. For mobile-bearing UKA, only lateral PFJ degeneration significantly decreased the OKS (MD = −2.21, P < 0.01) and KSS (MD = −2.44, P < 0.01). For fixed-bearing UKA, no correlation was found between PROMs/revision rates and PFJ degeneration.
Conclusion:. For medial mobile-bearing UKA, slight to moderate degenerative changes in the PFJ, except lateral facet, did not compromise PROMs or revision rates. For medial fixed-bearing UKA, although it might not be conclusive enough, PROMs or revision rates were not adversely affected by PFJ degeneration (regardless of the facet). |
| first_indexed | 2024-03-13T01:05:43Z |
| format | Article |
| id | doaj.art-39632b7244494be6b246afe3695e75f5 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 2542-5641 |
| language | English |
| last_indexed | 2024-03-13T01:05:43Z |
| publishDate | 2023-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-39632b7244494be6b246afe3695e75f52023-07-06T06:34:29ZengWolters KluwerChinese Medical Journal0366-69992542-56412023-07-01136131539155010.1097/CM9.0000000000002099202307050-00004Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplastyLimin Wu0Quan Chen1Haibo Si2Yuangang Wu3Yi Zeng4Mingyang Li5Yuan Liu6Bin Shen7Ningning Wang8Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.Abstract. Background:. Patellofemoral joint (PFJ) degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty (UKA). More recently, some researchers have proposed that PFJ degeneration can be ignored in medial UKA, and others have proposed that this change should be reviewed in PFJ degenerative facets and severity. This study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures (PROMs) and revision rates after medial UKA. Methods:. Electronic databases (PubMed, Embase, Web of Science, etc.) were searched for studies assessing the influence of PFJ degeneration on medial UKA. A random-effects meta-analysis was conducted for the Oxford knee score (OKS), Knee society score (KSS), and revision rates and stratified by PFJ degenerative facets (medial/lateral/trochlear/unspecified), severe PFJ degeneration (bone exposed), and bearing type (mobile/fixed). Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared statistic. Results:. A total of 34 articles with 7007 knees (2267 with PFJ degeneration) were included (5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified). Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS, and only lateral facets significantly decreased the OKS (mean difference [MD] = −2.18, P < 0.01) and KSS (MD = −2.61, P < 0.01). The severity degree of PFJ degeneration had no additional adverse effect on the OKS, KSS, or revision rates. For mobile-bearing UKA, only lateral PFJ degeneration significantly decreased the OKS (MD = −2.21, P < 0.01) and KSS (MD = −2.44, P < 0.01). For fixed-bearing UKA, no correlation was found between PROMs/revision rates and PFJ degeneration. Conclusion:. For medial mobile-bearing UKA, slight to moderate degenerative changes in the PFJ, except lateral facet, did not compromise PROMs or revision rates. For medial fixed-bearing UKA, although it might not be conclusive enough, PROMs or revision rates were not adversely affected by PFJ degeneration (regardless of the facet).http://journals.lww.com/10.1097/CM9.0000000000002099 |
| spellingShingle | Limin Wu Quan Chen Haibo Si Yuangang Wu Yi Zeng Mingyang Li Yuan Liu Bin Shen Ningning Wang Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty Chinese Medical Journal |
| title | Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| title_full | Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| title_fullStr | Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| title_full_unstemmed | Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| title_short | Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| title_sort | influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty |
| url | http://journals.lww.com/10.1097/CM9.0000000000002099 |
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