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Slight cartilage damage in weight-bearing area of lateral femoral condyle do not compromise short-term outcomes of medial unicompartmental knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Medial unicompartmental knee arthroplasty (mUKA) requires full-thickness cartilage in the lateral compartment, but slight damage of the cartilage surface can be ignored. However, as this statement lacks literature support, we investigated whether slight cartilage damages in the weight-bearing area of the lateral femoral condyle would affect the outcome of mUKAs.

Materials and methods

Outerbridge grading was performed on the cartilage in the weight-bearing area of the lateral femoral condyle intraoperatively. The patients, grouped as normal or as having lateral condyle cartilage of Outerbridge grade 1–2 (slight cartilage damage), underwent mUKA. Full-length lower extremity radiographs were taken and hip–knee–ankle angles (HKAAs) were measured both preoperatively and postoperatively. Using magnetic resonance imaging, the lateral meniscal extrusion distance was also measured. In addition, the Oxford Knee Score (OKS) was assessed preoperatively and at the last follow-up, in addition to the patient satisfaction assessment.

Results

We enrolled 152 knees of 142 patients proposed for mUKAs. The mean age of participants was 69.5 years (51–89 years) and they were followed up for a mean of 25.4 months (15–44 months). There was no significant difference in preoperative (p = 0.746) and postoperative (p = 0.202) mean OKS between the normal, Outerbridge grade 1 and Outerbridge grade 2 groups. While the normal group had a higher change in OKS than the group with cartilage damage, this difference was not significant (p = 0.910). The UKA corrected the patients’ mean HKAA from 171.1° (preoperatively) to 176.1° (postoperatively). From all patients, only four had slight lateral meniscus extrusion with MEDs of ≤ 0.25 mm. With the exception of one patient with a poor outcome in normal group, the rest were satisfied with the outcome of mUKA. No patients had prosthesis-related complications or revision surgery.

Conclusions

Cartilage damage of Outerbridge grade 1 and grade 2 in the weight-bearing area of the lateral femoral condyle will not compromise the short-term outcome of medial mobile-bearing UKA.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This work was supported by Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support, grant number: XMLX202139.

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Author notes

  1. Xufeng Jiao and Shuai An have contributed equally to this work and should be regarded as co-first authors

Authors and Affiliations

  1. Department of Orthopedics, Xuanwu Hospital Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China

    Xufeng Jiao, Shuai An, Guanglei Cao, Zheng Li, Mingli Feng & Jiang Huang

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  1. Xufeng Jiao
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  2. Shuai An
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  3. Guanglei Cao
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  4. Zheng Li
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  5. Mingli Feng
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  6. Jiang Huang
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Contributions

XJ and SA carried out study design, image measurement, data collection and article writing. ZL and JH were responsible for image measurement and data collection. GC and MF participated in all operations, directed the study design and article revision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Guanglei Cao.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study has been approved by the ethics committee of Xuanwu Hospital Capital Medical University.

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Informed consent was obtained from all individual participants included in the study.

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Jiao, X., An, S., Cao, G. et al. Slight cartilage damage in weight-bearing area of lateral femoral condyle do not compromise short-term outcomes of medial unicompartmental knee arthroplasty. Arch Orthop Trauma Surg 142, 3949–3955 (2022). https://doi.org/10.1007/s00402-021-04254-8

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  • DOI: https://doi.org/10.1007/s00402-021-04254-8

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