Localization of the full‐thickness cartilage lesions in medial and lateral unicompartmental knee osteoarthritis

Abstract

This study's aim was to determine the patterns of osteoarthritis (OA) in both unicompartmental medial and lateral OA of the knee. Forty patients with medial and 20 with lateral unicompartmental knee osteoarthritis were studied to determine the location of fullthickness cartilage lesions. Intraoperatively, the distance between margins of the lesion and reference lines were measured. The femoral measurements were transposed onto lateral radiographs to determine the relationship between the lesion site and knee flexion angles. Both tibial and femoral lesions were significantly (p < 0.01) more posterior in lateral OA than medial OA. In medial OA, the lesion center was, on average, at 118 (SD 38) of flexion, whereas in lateral OA, it was at 408 (SD 38). The smallest medial femoral lesions were near full extension and, as they enlarged, they extended posteriorly. The smallest lateral femoral lesions extended from 208 to 608 flexion. As these lesions enlarged, they extended both anteriorly and posteriorly. There was a well-defined relationship between the site of the lesions and their size, suggesting that they develop and progress in a predictable manner. The relationship was different for medial and lateral OA, suggesting that different mechanical factors are important in initiating the different types of OA. The lesions in medial OA occur in extension, perhaps initiated by events occurring at heel strike. The lesions in lateral OA begin at flexion angles above those occurring during the single leg stance phase of the gait cycle, so activities other than gait are likely to induce lateral OA. ß

Patterns of Femoral Cartilage Thickness are Different in Asymptomatic and Osteoarthritic Knees and Can be Used to Detect Disease-Related Differences Between Samples

“…These regions are of primary interest in a first analysis of the cartilage thickness shape because articular cartilage thickness and metabolism have been shown to locally adapt in response to applied loads [2,[23][24][25], knee loading has been reported to change with OA progression [26][27][28][29], and OA-related cartilage lesions have been associated with areas of high mechanical stress [30]. These three regions also agree with typical injury sites and the location of full-thickness lesions in the femoral cartilage [31,32], further supporting their selection for this study.…”

“…The main motivations for this choice were that it facilitates the normalization process and allows for an objective comparison with mean thickness measurements. Finally, while this first study of thickness shape focused on three regions selected based on previous publications [2,[20][21][22][23][24][25][26][27][28][29][30][31][32], the method is not limited to these regions. Future work should, therefore, also analyze regions that are less frequently discussed in the OA literature.…”

The pattern of cartilage damage in antero‐medial osteoarthritis of the knee and its relationship to the anterior cruciate ligament

“…It was inspected intra-operatively and, in all cases, demonstrated full thickness cartilage loss in a mirrored location as demonstrated by previous work by Gulati et al 15 The technique used removes this cartilage using a bone mill. Similarly, due to the minimally invasive nature of the operation, it is not possible to accurately document the position of the menisci.…”

Moderne unikondyläre Kniearthroplastik

“…Bei der ligamentären Balance von Streckund Beugespalt sollten das jeweilige Arthrosemuster [15], der Typ der Achsdeformität (. Abb.…”