Bicompartmental Versus Total Knee Arthroplasty for Medio-patellofemoral Osteoarthritis: A Comparison of Early Clinical and Functional Outcomes

Abstract

Severe medio-patellofemoral osteoarthritis (MPFOA) is often managed with a total knee arthroplasty (TKA). Bicompartmental knee arthroplasty (BKA), as compared with TKA can offer a bone and ligament preserving solution for MPFOA. We aimed to compare the early clinical and functional outcomes of modular BKA (n = 16) with TKA (n = 20) in MPFOA. Knee Society Score (KSS-clinical and function scores) and Knee injury & Osteoarthritis Outcome Score (KOOS-pain, symptoms, stiffness, and function scores) were recorded at 6, 12 and 24 months postoperatively and compared between the two groups. Pre- and postoperative radiographs were evaluated for alignment and radiolucencies. We found that none of the outcome scores were significantly different (p ≥ 0.137) between the two groups at any point in time. Postoperative knee range of motion (ROM) was significantly greater in the BKA group at all points in time (p ≤ 0.007). None of the patients in either group were revised or pending revision at the end of 24 months. To conclude, modular BKA resulted in better knee ROM but similar clinical and functional scores than TKA in MPFOA at short term. Modular BKA is a viable option for MPFOA but may not necessarily result in significant superior functional outcomes than with TKA.

Evaluation of implant fit and frontal plane alignment after bi-compartmental knee arthroplasty using patient-specific instruments and implants

“…The existing clinical data on off-the-shelf BKA using modular or mono-block implant systems demonstrate inferior overall survival of BKA compared to TKA [ 8 , 9 ]. Shah et al observed a significantly greater range of motion in BKA patients compared to TKA, but nearly similar clinical and functional scores between both approaches at 24-month follow-up [ 31 ]. Morrison et al reported a markedly higher short-term complication rate in BKA (28.6%) compared to TKA (6.1%) [ 32 ].…”

Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis

“…In total, 6 studies were selected for inclusion in the meta-analysis, as shown in the PRISMA flow diagram ( Fig. 1 ) [13] , [14] , [15] , [16] , [17] , [18] . A kappa value of 0.9 was determined based on the selections of two reviewers (S. K. and H.…”

“…2013 [14] Retrospective cohort IIB Modular 15 12 52 60 10:5 7:5 26 (4.2) 28.3 (4.9) 6 m, 1, 2 0 0 0 0 Shah et al. 2013 [15] Retrospective cohort IIB Modular 16 20 52.1 (6.4) 65.1 (7.5) 10:6 16:4 27.6 (4.4) 27.3 (3.8) 6 m, 1, 2 1 0 0 0 Morrison et al. 2011 [17] Prospective cohort IA Monolith 21 33 63.2 (11.5) 67.18 (9.5) 14:6 25:6 31.7 (7.7) 33.7 (8.6) 3 m, 1, 2 3 2 3 0 Total 133 144 76:35 85:34 6 6 7 2 BMI, body mass index; RCT, randomized controlled trial.…”