Comparison of Removing and Non-removing Patellofemoral Joint Osteophytes Following Medial Unicompartment Knee Arthroplasty

Study Overview
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Brief Summary
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Background: Anterior knee pain (AKP) is a challenge following unicompartmental knee arthroplasty (UKA). Some surgeons remove patellofemoral joint (PFJ) osteophytes to reduce osteophyte impingement and AKP. However, there is evidence that PFJ osteophytes compensate for knee osteoarthritis (OA) by increasing and improving stability and increase contract surface area in knee osteoarthritis. Moreover, when PFJ osteophytes are not removed, some studies report good clinical outcomes. The issue of removing or leaving PFJ osteophytes is controversial. The objective of this study was to compare AKP following mobile bearing UKA after removing or leaving PFJ osteophytes. Methods: The prospective non-randomized study included 89 isolated medial osteoarthritis (OA) of knee. They were classified into 2 groups. Group (Gp)1 was removing PFJ osteophytes; consists of 44 knees. Gp2 was non-removing PFJ osteophytes: consists of 45 knees. The patients were follow up and recorded incidence of AKP and VAS for AKP at 6 weeks, 3months, 6 months, 1 year and 2 years. No patients were lost to follow up. The patellar tilt and shift were measured at 6 weeks, 3months, 6months, 1year and 2 years via skyline view radiography. The knee society scores, Oxford knee score, knee injury and osteoarthritis outcome score, forgotten joint score and Kujala scale also were recorede at 6 weeks, 3months, 6months, 1 year and 2 years.

Detailed Description
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Removing and non-removing osteophyte at patellofemoral joint is controversial topic. The osteophyte may help to reduce load and improve stability of patellofemoral joint. Therefore, the purpose of this study is to compared anterior knee pain between removing and non-removing osteophyte at patellofemoral joint following medial mobile bearing unicompartmental knee arthroplasty

Official Title
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Does Removing Patellofemoral Joint Osteophytes Reduce Anterior Knee Pain Following Unicompartment Knee Arthroplasty?

Conditions
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Anterior Knee Pain

Intervention / Treatment
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* Procedure: removing osteophyte at patellofemoral joint


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 42 years old range of motion > 90 degrees flexion contracture< 15 degrees normal function of anterior cruciate ligament Exclusion Criteria: spontaneous osteonecrosis of the knee inflammatory joinr arthritis full thickness cartilage loss at lateral compartment

Ages Eligible for Study
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Minimum Age: 43 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| removing patellofemoral joint osteophytes<br>remove osteophyte at patella, medial femoral condyle and lateral femoral condyle | Procedure: removing osteophyte at patellofemoral joint<br>* to compare anterior knee pain between removing patellofemoral joint osteophytes and non-removing patellofemoral joint osteophytes after medial unicompartmental knee arthroplasty<br>|
| non-removing patellofemoral joint osteophytes<br>no remove osteophyte at patella, medial femoral condyle and lateral femoral condyle | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of anterior knee pain | number of participant that had anterior knee pain | 6 weeks | 
| incidence of anterior knee pain | number of participant that had anterior knee pain | 3 months | 
| incidence of anterior knee pain | number of participant that had anterior knee pain | 6 months | 
| incidence of anterior knee pain | number of participant that had anterior knee pain | 1 year | 
| incidence of anterior knee pain | number of participant that had anterior knee pain | 2 year | 
| Visual analogue scale for anterior knee pain | pain score 0= no pain and pain score 10= maximum pain | 6 weeks | 
| Visual analogue scale for anterior knee pain | pain score 0= no pain and pain score 10= maximum pain | 3 months | 
| Visual analogue scale for anterior knee pain | pain score 0= no pain and pain score 10= maximum pain | 6 months | 
| Visual analogue scale for anterior knee pain | pain score 0= no pain and pain score 10= maximum pain | 1 year | 
| Visual analogue scale for anterior knee pain | pain score 0= no pain and pain score 10= maximum pain | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patellofemoral osteophyte, anteromedial osteoarthritis knee, mobile bearing UKA, patellofemoral pain