Lateral unicompartmental replacement and facetectomy

Unicompartmental Knee Arthroplasty (UKA) is a treatment option in patients with unicompartmental degenerative disease. Advantages over Total Knee Arthroplasty (TKA) such as accelerated recovery and cruciate ligament retention have encouraged expansion of indication for UKA to patients with patellofemoral disease. Symptomatic lateral patellofemoral joint degenerative disease is common cause of UKA revision. Partial lateral patellar facetectomy can provide relief from symptoms of lateral patellofemoral degenerative disease. We hypothesize that simultaneous UKA and lateral patellar facetectomy provides durable pain relief and functional improvement in a patient population with degenerative disease of one tibiofemoral compartment and the lateral patellofemoral joint.Between 1998 and 2009, 303 prostheses were implanted with 123 laterals UKA. Eleven UKAs were performed in association with partial lateral patellar facetectomy in eleven female patients (mean age 66,7 years) with degenerative changes in one tibiofemoral compartment and the lateral patellofemoral joint. Patients were followed clinically and radiographically for a mean of 60 months.No patient underwent revision surgery in the follow-up period. Ninety per cent patients were satisfied with their knee function at final follow-up. The mean IKS knee score improved from 64,9 points pre-operatively to 87,5 points (range : 60 to 100 points) at final follow-up. The mean IKS functional score improved from 65,9 points pre-operatively to a mean of 83,2 points (range: 40 : to 100 points) at final follow-up.Simultaneous UKA and partial lateral patellar facetectomy is a viable treatment option for symptomatic degenerative disease involving one tibiofemoralcompartment and the lateral patellofemoral joint. Durable pain control and functional improvement were noted at medium-term follow-up. This treatment approach may be a useful alternative to TKA in a carefully selected patient population.