Efficacy and mid/long-term survivorship of mobile-bearing unicompartmental knee arthroplasty for medial compartment knee osteoarthritis combined patellofemoral joint arthritis: a prospective cohort study protocol

BMJ Open. 2020 Oct 7;10(10):e038448. doi: 10.1136/bmjopen-2020-038448.

Abstract

Introduction: Unicompartmental knee arthroplasty (UKA) is one of the most effective surgical procedures for treating isolated medial compartment knee osteoarthritis. However, previous studies have regarded patellofemoral osteoarthritis as a contraindication for UKA. In contrast, most current research shows that damage to the articular cartilage of the patellofemoral joint, even to the extent of full-thickness cartilage loss, has no influence on the outcome of UKA.

Methods and analysis: Study settings: This study is a prospective cohort study that will compare the Forgotten Joint Score and Lonner patellofemoral joint score of patients who have undergone UKA; the patients will be divided into two groups (with and without patellofemoral joint osteoarthritis (PFJOA)).

Primary objective: Long-term follow-up will be used to evaluate the effect of the operation on the above-mentioned scores in both the groups.

Secondary objective: We will divide the patients from the with PFJOA group into three subgroups according to the localisation of patellofemoral cartilage lesions (medial zone, lateral zone and central zone). We aim to compare knee joint scores among these groups and clarify the impact of different wear sites on clinical efficacy. We will use CT to explore the potential mechanism through which UKA affects patellofemoral joint-related parameters (lateral patellar tilt, lateral patellar shift and tibia tuberosity-trochlear groove distance). We will also record mid-term/long-term post-surgery complications.

Ethics and dissemination: This study's protocol is in accordance with the Declaration of Helsinki. This study was approved by the Ethics Committee of Xuanwu Hospital. The results of this study will be disseminated in international peer-reviewed journals.

Trial registration number: ChiCTR2000030310.

Keywords: adult orthopaedics; knee; musculoskeletal disorders; orthopaedic & trauma surgery.

MeSH terms

  • Arthroplasty, Replacement, Knee*
  • Cohort Studies
  • Humans
  • Knee Joint / pathology
  • Knee Joint / surgery
  • Knee Prosthesis*
  • Osteoarthritis, Knee* / diagnostic imaging
  • Osteoarthritis, Knee* / pathology
  • Osteoarthritis, Knee* / surgery
  • Patellofemoral Joint* / diagnostic imaging
  • Patellofemoral Joint* / pathology
  • Patellofemoral Joint* / surgery
  • Prospective Studies
  • Survivorship
  • Treatment Outcome