Short-term Clinical Efficacy Study Of Using Oxford Unicompartmental Knee Arthroplasty For Treating Partial Thickness Cartilage Loss

Objective:The primary indication for Oxford unicompartmental knee arthroplasty(UKA)is the presence of full-thickness cartilage loss(FTCL)in anterior medial osteoarthritis(AMOA).However,there is a debate on whether UKA can be performed in patients with partial-thickness cartilage loss(PTCL).This study aims to compare the clinical effectiveness of UKA in patients with both PTCL and FTCL.Method:A retrospective analysis was conducted on patients who had undergone UKA for AMOA between January 2019 and January 2022,and 60 patients were included in the study according to inclusion and exclusion criteria.Two senior surgeons evaluated the types of cartilage defects in the medial compartment,based on the International Cartilage Repair Society classification system,using intraoperative findings and preoperative MRI.The patients were divided into 40 cases of PTCL(19 cases with femoral PTCL only and 21 cases with tibial PTCL only)and 20 cases of FTCL.Patients were categorized into three groups based on their knee X-ray K-L grades: 20 FTCL patients(K-L grades 3/4),16 PTCL patients(K-L grade 2),and 24 PTCL patients(K-L grade 3).The clinical efficacy of PTCL and FTCL patients was evaluated at the last follow-up based on the Oxford Knee Score(OKS),Forgotten Joint Score-12(FJS-12),and Knee injury and Osteoarthritis Outcome Score(KOOS).Results:All patients were followed up for at least one year.There were no significant differences in age(P=0.871),gender(P=0.358),left or right side(P=0.469),BMI(P=0.423),and follow-up time(P=0.680)among the three groups,including FTCL(n=20),isolated femoral PTCL(n=19),and isolated tibial PTCL(n=21).The postoperative OKS,FJS-12,and KOOS scores of patients with isolated tibial PTCL and isolated femoral PTCL were lower than those of the FTCL group,but there was no significant statistical difference.The postoperative OKS,FJS-12,and KOOS scores of PTCL(K-L grade 3)patients were comparable to those of FTCL(K-L grades 3/4)patients,with no significant statistical difference.However,the postoperative OKS,FJS-12,and KOOS scores of PTCL(K-L grade 2)patients were significantly lower than those of FTCL(K-L grades 3/4)and PTCL(K-L grade 3)patients,but the results were not significantly different statistically.No patients required revision or further surgery.Conclusion:Oxford unicompartmental knee arthroplasty(UKA)can achieve satisfactory clinical results in the treatment of PTCL in anteromedial osteoarthritis(AMOA).However,for patients with PTCL only involving the tibia or with K-L grade 2,caution should be exercised when selecting UKA as a treatment option.