The phenotypic diversity of anteromedial osteoarthritis before and after treatment with medial unicompartmental knee arthroplasty : A radiographic analysis of 1000 knees

© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy..

PURPOSE: This study aimed to assess phenotypic variation in the coronal plane of knees with anteromedial osteoarthritis using the functional knee phenotype classification, before and after treatment with medial unicompartmental knee arthroplasty (UKA).

METHODS: The study comprised 1000 knees of 835 patients (45% females, 55% males, 90% Caucasian) who underwent medial UKA for anteromedial osteoarthritis. Pre and postoperative alignment was evaluated through the hip-knee-ankle angle (HKA), femoral mechanical angle (FMA), and tibial mechanical angle (TMA). Knees were classified according to the functional knee phenotype system which combines limb phenotype (HKA), and femoral and tibial knee phenotypes (FMA and TMA, respectively). Restoration of prearthritic coronal alignment following medial UKA was evaluated by phenotype.

RESULTS: Preoperatively, 76 distinct and 25 relevant (prevalence ≥1%) functional knee phenotypes were identified, of which VARHKA 6°VARFMA 3°NEUTMA 0° was the most common (9.4% of knees). The most prevalent limb phenotype, VARHKA 6°, comprised 15 distinct knee phenotypes (FMA and TMA combinations). Postoperatively, 58 distinct and 17 relevant functional knee phenotypes were observed, of which VARHKA 3°NEUFMA 0°NEUTMA 0° had the highest prevalence at 18.3%. Knees with combined tibial and femoral deformities were associated with a lower probability of restoration of prearthritic coronal alignment following medial UKA, compared to knees without extra-articular deformity, or knees with an isolated tibial or femoral deformity.

CONCLUSION: Phenotype analysis using the functional knee phenotype system demonstrated a wide diversity of coronal alignment phenotypes among knees with anteromedial osteoarthritis in a predominantly Caucasian population. Following medial UKA, a reduction from 25 preoperative to 17 postoperative relevant phenotypes was observed. Consideration of phenotypic variation can be of importance when aiming to restore prearthritic coronal alignment during medial UKA.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA - 32(2024), 2 vom: 12. Feb., Seite 274-286

Sprache:

Englisch

Beteiligte Personen:

Bayoumi, Tarik [VerfasserIn]
Ten Noever de Brauw, Gaby V [VerfasserIn]
Ruderman, Lindsey V [VerfasserIn]
van der List, Jelle P [VerfasserIn]
Kerkhoffs, Gino M M J [VerfasserIn]
Pearle, Andrew D [VerfasserIn]
Zuiderbaan, Hendrik A [VerfasserIn]

Links:

Volltext

Themen:

Coronal alignment
Journal Article
Knee phenotypes
Prearthritic alignment
Robotic-assisted surgery
Unicompartmental knee arthroplasty

Anmerkungen:

Date Completed 14.02.2024

Date Revised 14.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/ksa.12043

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367169924