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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Influence of the anterior notch in mobile-bearing UKA on patellofemoral radiotracer uptake and clinical outcome

Authors: Dietmar Dammerer, Michael Liebensteiner, Hannes Rochau, Christian Uprimny, Vinzenz Smekal, Ralf Rosenberger, Elvire Servien

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Previous studies reported that in partial knee arthroplasty smooth transitions to the remaining native parts of the knee are important. However, in mobile-bearing unicondylar knee arthroplasty (UKA) it is mandatory to create an anterior osteochondral notch adjacent to the femoral component to get clearance for the anterior lip of the bearing in full knee extension. This notch is, however, part of the femoral trochlea.
It was the aim of the study to test for a potential association between a) an obligatory anterior notch in mobile-bearing UKA located at the margin of the medial aspect of the femoral trochlea and b) postoperative patellofemoral joint (PFJ) bone remodelling and discomfort.

Methods

In patients who underwent routine mobile-bearing UKA (11 male, 13 female; 64.5 years / IQR 14) the following parameters were prospectively determined i) size of the surgically created anterior notch, ii) knee score sensitive to PFJ disorders, iii) bone remodelling in the PFJ (radiotracer uptake in SPECT-CT).

Results

Notch size was not correlated with radiotracer uptake at the PFJ. Similarly, no significant correlations were observed between radiotracer uptake (patella or trochleocondylar junction) and knee scores (KOOS or Kujala Score). Significant positive correlations were found between notch size and knee scores.

Conclusions

From the findings made in our study it is concluded that a larger size of the anterior notch in mobile-bearing medial Oxford UKA is not associated with increased osteochondral remodelling processes at the patella or the trochleocondylar junction. Neither is a larger sized notch associated with worse clinical PFJ outcome. Surprisingly, a larger notch was even associated with superior clinical outcome. The exact mechanism for this contraintuitive finding remains unclear but may be the basis for future research.

Trial registration

The study is registered in a public trials registry. Link: (9/12/2017) ClinicalTrials.gov. NCT01407042; Date of registration: July, 26, 2011.
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Metadata
Title
Influence of the anterior notch in mobile-bearing UKA on patellofemoral radiotracer uptake and clinical outcome
Authors
Dietmar Dammerer
Michael Liebensteiner
Hannes Rochau
Christian Uprimny
Vinzenz Smekal
Ralf Rosenberger
Elvire Servien
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1885-6

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