LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE

Gulati A, Chau R, Palan J, et al. LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE. Orthop Procs. 2009;91-B(SUPP_III):422-422. doi:10.1302/0301-620X.91BSUPP_III.0910422d

Gulati, A, et al. “LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE.” Orthopaedic Proceedings, vol. 91-B, no. SUPP_III, 2009, pp. 422-422., https://doi.org/10.1302/0301-620X.91BSUPP_III.0910422d

Gulati, A., Chau, R., Palan, J., Rout, R., Dodd, C., Price, A., Gill, H., & Murray, D. (2009). LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE. Orthopaedic Proceedings, 91-B(SUPP_III), 422-422. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910422d

Gulati, A., Chau, R., Palan, J., Rout, R., Dodd, C., Price, A. et al. (2009) “LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE.” Orthopaedic Proceedings, 91-B(SUPP_III), pp. 422-422. Available at: https://doi.org/10.1302/0301-620X.91BSUPP_III.0910422d

Gulati, A, R Chau, J Palan, R Rout, CAF Dodd, AJ Price, HS Gill, and DW Murray. “LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE.” Orthopaedic Proceedings 91-B, no. SUPP_III (2009): 422-422. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910422d

Gulati A, Chau R, Palan J, Rout R, Dodd C, Price A, et al. LOCALISATION OF THE LESION IN UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE. Orthop Procs. 2009 Sep 1;91-B(SUPP_III):422-422. https://doi.org/10.1302/0301-620X.91BSUPP_III.0910422d

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Abstract

Purpose: To compare the site of lesions in medial and lateral unicompartmental osteoarthritis (OA) of the knee.

Methods: Patients with medial (n=35) and lateral (n=15) OA, having unicompartmental knee arthroplasty, were recruited. Intra-operatively, the distance between the anterior, posterior, medial and lateral margins of the full-thickness lesion and reference lines dividing the condyles was measured. The midpoints of lesions were calculated and groups were compared. Lateral radiographs were used to determine the relationship between the lesion site and knee flexion angle (KFA).

Results: Femoral lesion: In lateral OA, the midpoint of lesions was 25.0mm (SD:8.8) posterior to the reference line passing transversely through the apex of the inter-condylar notch. This was significantly different (p< 0.001) from midpoint in medial OA, which was 10.7mm (SD:9.4) posterior to the reference line.

Tibial lesion: In lateral OA, the midpoint of lesions was 2.0mm (SD:6.5) posterior to the reference line passing through the mid-coronal plane of the resected tibia. This was located significantly more posterior (p=0.038) than midpoint in medial OA, which was 2.2mm (SD:5.7) anterior to the reference line.

Knee Flexion Angle: In lateral OA, the midpoint of lesions was on average at 40° flexion and sites of smaller lesions were very variable. The lesion expanded both anteriorly and posteriorly. In medial OA, smaller femoral lesions occurred in full extension and extended further posteriorly with disease progression.

No significant difference was demonstrated in medial and lateral localisation of the lesions.

Conclusion: Medial OA begins near full extension, progresses in a predictable manner and is perhaps initiated by events occurring at heel strike. Lateral OA begins in flexion in a less predictable manner, at KFA above that seen during the gait cycle. The different sites of lesions in medial and lateral OA suggest different aetiology and pathophysiology. Therefore, prevention and treatment strategies should be different.

Correspondence should be addressed to Mr T Wilton, c/o BOA, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.