Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 4/2009

01-04-2009 | Orthopaedic Outcome Assessment

Patellar height before and after unicompartmental knee arthroplasty: association with early clinical outcome?

Authors: Florian D. Naal, Carl Neuerburg, Fabian von Knoch, Gian M. Salzmann, Monika Kriner, Urs Munzinger

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2009

Login to get access

Abstract

Introduction

There is paucity of information available concerning the role of patellar height in unicompartmental knee arthroplasty (UKA). The present study was conducted to determine the patellar height before and after UKA and to assess possible effects on the early clinical outcome.

Materials and methods

We measured the patellar height before and after UKA in 83 consecutive knees using the Blackburne–Peel (BP) index and Insall–Salvati (IS) ratio and investigated the impact of the patellar height on the clinical outcome 2 years after surgery.

Results

BP values significantly decreased from 0.81 before surgery to 0.76 postoperatively (P < 0.001). IS ratios did not significantly decrease from 1.02 to 1.01 (P = 0.108). Lower preoperative BP values were negatively correlated with the postoperative knee extension (r = −0.357, P = 0.026), while higher preoperative BP values were negatively associated with the postoperative Knee Society Score (r = −0.302, P = 0.046). Lower preoperative IS values were negatively correlated with postoperative Knee Scores (r = −0.394, P = 0.019).

Conclusion

After UKA, the patellar height decreased significantly according to the BP index, but not significantly according to the IS ratio. We found only weak and inconsistent correlations between the patellar height and clinical outcome parameters. Hence, based on the present results, the patellar height seems not to be a strict separate patient-selection criterion for UKA.
Literature
1.
go back to reference O`Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, Sullivan PM, Johnston RC (2005) The John Insall Award. Unicompartmental knee replacement: a minimum twenty-one-year follow up, end-result study. Clin Orthop Relat Res 440:27–37CrossRef O`Rourke MR, Gardner JJ, Callaghan JJ, Liu SS, Goetz DD, Vittetoe DA, Sullivan PM, Johnston RC (2005) The John Insall Award. Unicompartmental knee replacement: a minimum twenty-one-year follow up, end-result study. Clin Orthop Relat Res 440:27–37CrossRef
2.
go back to reference Price AJ, Waite CJ, Svard U (2005) Long term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 435:171–180PubMedCrossRef Price AJ, Waite CJ, Svard U (2005) Long term clinical results of the medial Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res 435:171–180PubMedCrossRef
3.
go back to reference Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC (1999) Unicompartmental knee replacement: a minimum 15 year follow-up study. Clin Orthop Relat Res 367:61–72PubMedCrossRef Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC (1999) Unicompartmental knee replacement: a minimum 15 year follow-up study. Clin Orthop Relat Res 367:61–72PubMedCrossRef
4.
go back to reference Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH (2006) Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br 88B:164–168 Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH (2006) Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond ten years. J Bone Joint Surg Br 88B:164–168
5.
go back to reference Deshmukh RV, Scott RD (2002) Unicompartmental knee arthroplasty for younger patients: an alternative view. Clin Orthop Relat Res 404:108–112PubMedCrossRef Deshmukh RV, Scott RD (2002) Unicompartmental knee arthroplasty for younger patients: an alternative view. Clin Orthop Relat Res 404:108–112PubMedCrossRef
6.
go back to reference Kozinn SC, Scott RD (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71A:145–150 Kozinn SC, Scott RD (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71A:145–150
7.
go back to reference Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 87:999–1006PubMedCrossRef Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO (2005) Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am 87:999–1006PubMedCrossRef
8.
go back to reference Berger RA, Meneghini RM, Sheinkop MB, Della Valle CJ, Jacobs JJ, Rosenberg AG, Galante JO (2004) The progression of patellofemoral arthrosis after medial unicompartmental knee replacement: results at 11 to 15 years. Clin Orthop Relat Res 428:92–99PubMedCrossRef Berger RA, Meneghini RM, Sheinkop MB, Della Valle CJ, Jacobs JJ, Rosenberg AG, Galante JO (2004) The progression of patellofemoral arthrosis after medial unicompartmental knee replacement: results at 11 to 15 years. Clin Orthop Relat Res 428:92–99PubMedCrossRef
9.
go back to reference Hernigou P, Deschamps G (2002) Patellar impingement following unicompartmental knee arthroplasty. J Bone Joint Surg Am 84:1132–1137PubMed Hernigou P, Deschamps G (2002) Patellar impingement following unicompartmental knee arthroplasty. J Bone Joint Surg Am 84:1132–1137PubMed
10.
go back to reference Meneghini RM, Ritter MA, Pierson JL, Meding JB, Berend ME, Faris PM (2006) The effect of the Insall–Salvati ratio on the outcome after total knee arthroplasty. J Arthroplasty 21(6 Suppl 2):116–120PubMedCrossRef Meneghini RM, Ritter MA, Pierson JL, Meding JB, Berend ME, Faris PM (2006) The effect of the Insall–Salvati ratio on the outcome after total knee arthroplasty. J Arthroplasty 21(6 Suppl 2):116–120PubMedCrossRef
11.
go back to reference Gandhi R, de Beer J, Leone J, Petruccelli D, Winemaker M, Adili A (2006) Predictive risk factors for stiff knees in total knee arthroplasty. J Arthroplasty 21:46–52PubMedCrossRef Gandhi R, de Beer J, Leone J, Petruccelli D, Winemaker M, Adili A (2006) Predictive risk factors for stiff knees in total knee arthroplasty. J Arthroplasty 21:46–52PubMedCrossRef
12.
go back to reference Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43:752–757PubMed Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43:752–757PubMed
13.
go back to reference Brumby SA, Carrington R, Zayontz S, Reish T, Scott RD (2003) Tibial plateau stress fracture: a complication of unicompartmental knee arthroplasty using 4 guide pinholes. J Arthroplasty 18:809–812PubMedCrossRef Brumby SA, Carrington R, Zayontz S, Reish T, Scott RD (2003) Tibial plateau stress fracture: a complication of unicompartmental knee arthroplasty using 4 guide pinholes. J Arthroplasty 18:809–812PubMedCrossRef
14.
go back to reference Rudol G, Jackson MP, James SE (2007) Medial tibial plateau fracture complicating unicompartmental knee arthroplasty. J Arthroplasty 22:148–150PubMedCrossRef Rudol G, Jackson MP, James SE (2007) Medial tibial plateau fracture complicating unicompartmental knee arthroplasty. J Arthroplasty 22:148–150PubMedCrossRef
15.
go back to reference Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg Br 59:241–242PubMed Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg Br 59:241–242PubMed
16.
go back to reference Insall J, Salvati E (1977) Patella position in the normal knee joint. Radiology 101:101–104 Insall J, Salvati E (1977) Patella position in the normal knee joint. Radiology 101:101–104
17.
go back to reference Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13:890–895PubMedCrossRef Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13:890–895PubMedCrossRef
18.
go back to reference Price AJ, Oppold PT, Murray DW, Zavatsky AB (2006) Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement. J Bone Joint Surg Br 88:1591–1595PubMedCrossRef Price AJ, Oppold PT, Murray DW, Zavatsky AB (2006) Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement. J Bone Joint Surg Br 88:1591–1595PubMedCrossRef
19.
go back to reference Mann RW, Roberts CA, Thomas MD, Davy DT (1991) Pressure erosion of the femoral trochlea, patella baja, and altered patellar surfaces. Am J Phys Anthropol 85:321–327PubMedCrossRef Mann RW, Roberts CA, Thomas MD, Davy DT (1991) Pressure erosion of the femoral trochlea, patella baja, and altered patellar surfaces. Am J Phys Anthropol 85:321–327PubMedCrossRef
20.
go back to reference Weale AE, Murray DW, Newman JH, Ackroyd CE (1999) The length of the patellar tendon after unicompartmental knee replacement. J Bone Joint Surg Br 81:790–795PubMedCrossRef Weale AE, Murray DW, Newman JH, Ackroyd CE (1999) The length of the patellar tendon after unicompartmental knee replacement. J Bone Joint Surg Br 81:790–795PubMedCrossRef
21.
go back to reference Rogers BA, Thornton-Bott P, Cannon SR, Briggs TW (2006) Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg Br 88:484–488PubMedCrossRef Rogers BA, Thornton-Bott P, Cannon SR, Briggs TW (2006) Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg Br 88:484–488PubMedCrossRef
22.
go back to reference Seil R, Mueller B, Georg T, Kohn D, Rupp S (2000) Reliability and interobserver variability in radiological patellar height ratios. Knee Surg Sports Traumatol Arthrosc 8:231–236PubMedCrossRef Seil R, Mueller B, Georg T, Kohn D, Rupp S (2000) Reliability and interobserver variability in radiological patellar height ratios. Knee Surg Sports Traumatol Arthrosc 8:231–236PubMedCrossRef
23.
go back to reference Grelsamer RP (2002) Patella baja after total knee arthroplasty. Is it really patella baja? J Arthroplasty 17:66–69PubMedCrossRef Grelsamer RP (2002) Patella baja after total knee arthroplasty. Is it really patella baja? J Arthroplasty 17:66–69PubMedCrossRef
24.
go back to reference Maeno S, Kondo M, Niki Y, Matsumoto H (2006) Patellar impingement against the tibial component after total knee arthroplasty. Clin Orthop Relat Res 452:265–269PubMedCrossRef Maeno S, Kondo M, Niki Y, Matsumoto H (2006) Patellar impingement against the tibial component after total knee arthroplasty. Clin Orthop Relat Res 452:265–269PubMedCrossRef
25.
go back to reference Koshino T, Ejima M, Okamoto R, Morii T (1990) Gradual low riding of the patella during postoperative course after total knee arthroplasty in osteoarthritis and rheumatoid arthritis. J Arthroplasty 5:323–327PubMedCrossRef Koshino T, Ejima M, Okamoto R, Morii T (1990) Gradual low riding of the patella during postoperative course after total knee arthroplasty in osteoarthritis and rheumatoid arthritis. J Arthroplasty 5:323–327PubMedCrossRef
Metadata
Title
Patellar height before and after unicompartmental knee arthroplasty: association with early clinical outcome?
Authors
Florian D. Naal
Carl Neuerburg
Fabian von Knoch
Gian M. Salzmann
Monika Kriner
Urs Munzinger
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 4/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0654-2

Other articles of this Issue 4/2009

Archives of Orthopaedic and Trauma Surgery 4/2009 Go to the issue