ESSKA Instructional Course Lecture Book by Gino M.M.J. Kerkhoffs Fares Haddad Michael T. Hirschmann Jón Karlsson & Romain Seil

Author:Gino M.M.J. Kerkhoffs, Fares Haddad, Michael T. Hirschmann, Jón Karlsson & Romain Seil
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Lateral tibiofemoral TFOA visible on radiographs was thought to be a contraindication for medial UKA in varus OA. However, both UKA series of Berger et al. [12] and Pennington et al. [8] implanted UKA in the presence of asymptomatic lateral TFOA. They found little or slow progression of the disease over 10–15 years of follow-up without significant worsening of symptoms. Their patients had no progressive lateral joint pain and no revision for lateral TFOA. The key to this result may be the subtotal correction of the weight-bearing axis achieved. The mean femorotibial angle was 5°, which is a mild varus resulting in limited loading of the lateral TF joint space [8]. Marya and Thukral [16] took this concept to the limit by implanting a medial UKA in tricompartmental varus knee OA with symptoms confined to the medial tibiofemoral joint. In 45 low-demand older patients, medial UKA resulted in 96% survival and 95% good and excellent outcomes after 6 years mean follow-up. Therefore, candidates with isolated medial joint space symptoms for medial UKA that have visible early radiological signs of OA at the lateral tibiofemoral joint may still be treated successfully by isolated medial UKA.

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