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Preoperative anterior or lateral pain not a contraindication for medial UKA
Researchers compared patients with anterior, generalized or lateral pain to those with medial pain and found no functional differences.
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The location of a patient’s preoperative pain did not predict functional short-term outcomes of unicompartmental knee arthroplasty and should not be used as a surgical indication, according to researchers from the United Kingdom.
“Preoperative pain location has no effect on outcomes following Oxford unicompartmental knee arthroplasty (Biomet Inc.; Warsaw, Ind., USA),” Alex D. Liddle, MBBS, MRCS, of the University of Oxford Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, said during his presentation at the British Orthopaedic Association Congress.
Location of pain vs outcome
Liddle noted that although some investigators suggest that purely medial pain is a prerequisite for unicompartmental knee arthroplasty (UKA), other researchers highlight that there are good outcomes with UKA procedures in patients with severe, symptomatic osteoarthritis regardless of pain location.
To determine whether preoperative pain location had any bearing on UKA outcomes, Liddle and colleagues conducted a prospective cohort study of 308 patients (406 knees) undergoing medial UKA using the Oxford prosthesis. They interviewed patients preoperatively to determine the location of their pain. The minimum follow-up was 1 year and 132 patients reached 5 years follow-up.
Liddle and colleagues measured functional outcomes preoperatively, and at 1-year and 5-years postoperatively.
Comparisons
The results showed 204 patients had isolated medial compartment pain, 77 patients had anterior knee pain, 25 patients had isolated anterior knee pain and 40 patients experienced generalized pain.
“As you would expect, patients had improved significantly at 1 year compared to preoperatively, and this was maintained at 5 years,” Liddle said. “At 1 year, there was no difference between the groups, and this was again maintained at 5 years.”
The investigators conducted two additional analyses, one of which compared patients with anterior pain to those without such pain. The other analysis compared patients with purely medial pain to those with generalized, lateral or anterior knee pain. In both analyses, investigators discovered no significant differences in functional scores between the groups they compared.
“We conclude that localized medial pain should not be a pre-requisite to UKA, and that the procedure may be performed in patients with generalized or anterior knee pain,” Liddle and colleagues wrote in their study. – by Renee Blisard Buddle
- Reference:
- Liddle AD. Paper #66. Presented at: British Orthopaedic Association Congress; Sept. 11-14, 2012; Manchester.
- For more information:
- Alex D. Liddle, MBBS, MRCS, can be reached at Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Nuffield Orthopaedic Centre, University of Oxford, Windmill Rd., Headington, Oxford OX3 7YD, UK; email: alexander.liddle@ndorms.ox.ac.uk.
Disclosure: NDORMS receives institutional support from Biomet. Liddle has no personal conflicts of interest.