Influence of Bone Marrow Edema on Medial Unicompartmental Knee Arthroplasty among Patients with Patellofemoral Osteoarthritis
- 25 August 2017
- journal article
- research article
- Published by Georg Thieme Verlag KG in The Journal of Knee Surgery
- Vol. 30 (08), 816-821
- https://doi.org/10.1055/s-0037-1605560
Abstract
This study aims to compare clinical outcomes in unicompartmental knee arthroplasty (UKA) patients with or without magnetic resonance imaging (MRI) evidence of bone marrow edema (BME) in the patella and to evaluate the effect of functional outcomes after UKA in patients with patellofemoral osteoarthritis (PF OA). Outcomes of 146 knees in 141 patients who underwent medial UKA were included. According to their preoperative condition of patellofemoral joints, patients were divided into three groups: Group A, non-PF OA (Kellgren–Lawrence [K–L] scale = 0); group B, PF OA without BME (K–L ≥ 1, bone marrow edema pattern [BMEP] = 0); group C, PF OA with BME (K–L ≥ 1, BMEP ≥ 1). Clinical outcomes including visual analog scale (VAS) scores of knee pain, Hospital for Special Surgery (HSS) scores, and range of motions (ROMs) were evaluated and analyzed at the postoperative follow-up of 3 months and 2 years. From our results, BME was highly correlated to poor outcome in patients with UKA. At follow-up of 3 months, BME influenced the clinical outcome of UKA at an early postoperative stage in terms of VAS scores, HSS scores, and ROMs. At the final follow-up of 2 years, the clinical outcome was improved in terms of HSS score, although the anterior knee pain and active ROMs were still worse than that of patients without BME. In conclusion, there was no significant difference in clinical outcomes in patients without BME regardless of PF OA. However, the condition of BME should be taken serious consideration because of its indication of an adverse effect on the outcome after UKA.Keywords
This publication has 17 references indexed in Scilit:
- No difference in anterior knee pain after medial unicompartmental knee arthroplasty in patients with or without patellofemoral osteoarthritisKnee Surgery, Sports Traumatology, Arthroscopy, 2014
- UKA closely preserves natural knee kinematics in vitroKnee Surgery, Sports Traumatology, Arthroscopy, 2013
- Revision of Unicompartmental Arthroplasty to Total Knee Arthroplasty: Not Always a Slam Dunk!The Journal of Arthroplasty, 2013
- Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adultsArthritis Research & Therapy, 2010
- Joint space narrowing and Kellgren–Lawrence progression in knee osteoarthritis: an analytic literature synthesisOsteoarthritis and Cartilage, 2008
- Bone marrow edema in the knee in osteoarthrosis and association with total knee arthroplasty within a three-year follow-upSkeletal Radiology, 2008
- Mobile Bearing Unicompartmental Knee ReplacementOrthopedics, 2007
- Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacementsKnee Surgery, Sports Traumatology, Arthroscopy, 2005
- The Association of Bone Marrow Lesions with Pain in Knee OsteoarthritisAnnals of Internal Medicine, 2001
- Radiological Assessment of Osteo-ArthrosisAnnals Of The Rheumatic Diseases, 1957