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J Knee Surg 2017; 30(08): 816-821
DOI: 10.1055/s-0037-1605560
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influence of Bone Marrow Edema on Medial Unicompartmental Knee Arthroplasty among Patients with Patellofemoral Osteoarthritis

Jiaji Yue
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
2   Department of Sports Medicine and Joint Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
,
Xiaojun Ma
3   Department of Orthopedics, Shanghai Jiaotong University First People's Hospital, Shanghai, Shanghai, China
,
Yaqiang Li
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
,
Yu Wang
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
4   Department of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
,
Chunxi Yang
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
,
Yuchang Zhu
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
,
Biao Cheng
1   Department of Orthopedics, Shanghai Tenth People's Hospital, Shanghai, China
› Author Affiliations
Further Information

Publication History

03 June 2017

09 July 2017

Publication Date:
25 August 2017 (online)

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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

unicompartmental knee arthroplasty - patellofemoral osteoarthritis - clinical outcome - short-term results - bone marrow edema pattern