The Effect Of Knee Pain And Patellofemoral Degeneration On The Postoperative Treatment Of The Medial Compartment Of The Knee

Background: With the change of human living environment and living habits,the incidence of knee osteoarthritis in the elderly is second only to common diseases such as diabetes mellitus.However,more than half of the knee osteoarthritis Of the lesions were mostly confined to the medial compartment of theknee.Atpresent,unilateralcondylarknee replacement(UKAUnicompartmental Knee Arthroplasty)is considered the treatment of middle-aged patients with knee osteoarthritis of the medial compartment of the best choice,especially the minimally invasive single condyle replacement.Because UKA and TKA(TKA Total Knee Arthroplasty)compared to trauma,low mortality and low incidence of complications,but also reduce the pain of patients,more close to the physiological anatomy of the knee[1-4].However,UKA indications for surgery is still not very clear,many of which studies that patellofemoral arthritis UKA should be a contraindication,there are many scholars believe that this view is wrong.There have been several studies of patellofemoral arthritis as the most common cause of UKA revision [5-8].In addition,there are some scholars reported that the presence of degeneration of the patellofemoral joint does not affect the efficacy of UKA after surgery,so they think whether the UKA treatment,especially the use of mobile platform prosthesis,patellofemoral joint degeneration can be ignored[9-11].Objective: To study the effect of knee pain and patellofemoral joint degeneration on the postoperative therapeutic effect of minimally invasive single condylar art hroplasty(UKA)in the medial compartment of the medial compartment of knee joint for the treatment of medial arthritis of knee joint.Methods: From July 2013 to July 2015,86 patients with knee joint medial knee arthroplasty(UKA)treated by knee joint medial knee arthritis were treated by joint surgery of The second hospital affiliated to dalian medical universityfrom July 2013 to July 2015.Patients).Among them,15 cases were male and 71 were female.The age ranged from 42 to 81 years(mean 66.3 years).Patients had a body mass index(BMI)of 23to27 kg/m2 with an average of 25.3 kg/m2.According to the presence of preoperative knee pain,patients will be divided into two groups of knee pain and no knee pain.Preoperative evaluation of patellofemoral arthroplasty with the Altman classification and Ahlback score were performed in 86 patients.The knee was divided into medial normal group,medial retrograde group,lateral normal group and lateral degenerative group.Knee joint score(OKS score)and American Society of Knee Joint Score(AKS score)were used to evaluate the pain and function of knee joint before and after operation.SPSS software was used to analyze the AKS and OKS scores of the knee joint before and after the operation.The results were analyzed by t-test with the mean ± standard deviation(± s).Results:All patients were followed up for a mean of 15.6 months(range,12-24 months).All the patients had no postoperative infection,polyethylene liner dislocation,poor prosthesis position or loosening,periprosthetic fracture and other complications.OKS and AKS scores were significantly improved in all subjects after the last follow-up(P<0.01).There were no significant difference in the scores of OKS and AKS between the two groups(P> 0.05).The two groups were followed up for the last follow-up There was no significant difference between OKS and AKS scores(P> 0.05).The patients were divided into groups according to Ahlback and Altman’s assessment of patellofemoral joint degeneration.53 cases of normal medial patellofemoral joint,medial patellofemoral joint degeneration in 33 cases;lateral patellofemoral joint normal 74 cases,12 cases of lateral patellofemoral degeneration(according to Altman score).There were 77 cases of medial patellofemoral joint,9 cases of medial patellofemoral joint degeneration,80 cases of lateral patellofemoral joint and 6 cases of lateral patellofemoral joint degeneration(according to Ahlback classification).According to Ahlback and Altman,OKS and AKS scores were significantly improved(P <0.01)and patellofemoral degeneration in the patients with or without patellofemoral degeneration at the last follow-up There was no significant difference between the scores of OKS and AKS scores and the scores of OKS and AKS scores at the last follow-up(P> 0.05).There were no statistically significant differences in the scores of OKS and AKS scores between the two groups before and after the final follow-up of OKS and AKS scores in the two groups according to the Ahlback classification and patellar lateral degeneration.There were no significant differences in OKS and AKS scores between two groups before and after lateral patellofemoral degeneration according to Ahman score.There was no significant difference in OKS scores between the two groups at the last follow-up(P<0.05),but the AKS score of lateral patellofemoral degeneration was lower than that of patellofemoral degenerated patients at the last follow-up(-2.47,-2.06 P = 0.02 <0.05).Conclusion: The anterior knee pain and the medial degeneration of the patellofemoraljoint do not affect the medial compartment of the knee.The treatment of lateral condylar patellofemoraldegeneration is better than that of the patellofemoral joint.The lateral joint of the normal treatment of poor.