Application of the arthroscope in unicompartmental knee arthroplasty

ZHOU Bing-zheng; BAI Lun-hao; LI Bin

doi:10.3969/j.issn.2095-252X.2013.12.004

Abstract：Objective To investigate the application of the arthroscope in unicompartmental knee arthroplasty ( UKA ). Methods From March 2010 to May 2012, 31 patients ( 33 knees ) with medial compartment osteoarthritis who were scheduled to undergo UKA were treated by conventionally arthroscopic debridement. Based on the preoperative examination, imaging studies, intraoperative conditions and postoperative results, the application value of the arthroscope in UKA was analyzed. Results The arthroscopy showed that the lesions were mainly located in the medial compartment of the knee. The medial articular cartilage degeneration ( Outerbrige III-IV ) was found. The lateral articular cartilage was normal or presented degeneration (<Outerbrige II ), and degeneration ( Outerbrige I-II ) existed in 5 knees. Medial meniscus injuries and degeneration in different degrees was found in 24 knees, patellofemoral cartilage degeneration ( Outerbrige I-II ) in 10 knees and lateral meniscus injuries and degeneration in 6 knees. The posterolateral bundle ( PLB ) of the anterior cruciate ligament ( ACL ) was partly ruptured in 1 knee, and the patient underwent total knee arthroplasty ( TKA ) instead. According to the Hospital for Special Surgery Knee Scoring System ( HSS ), the mean scores were ( 67.56±2.929 ) points preoperatively and ( 90.22±3.816 ) points postoperatively, and the differences were statistically signiifcant ( t=24.992, P<0.05 ). The mean range of knee lfexion was ( 103.16±6.802 ) ° preoperatively and ( 114.75±4.765 ) ° postoperatively, and the differences were statistically significant ( t=11.666, P<0.05 ). The mean knee varus angle in the weight-bearing position was ( 12.16±2.102 ) ° preoperatively and ( 8.75±2.015 ) ° postoperatively, and the differences were statistically significant ( t=17.646, P<0.05 ). The mean lfexion contracture was ( 11.36±1.902 ) ° preoperatively and ( 6.75±2.632 ) ° postoperatively, and the differences were statistically significant ( t=16.036, P<0.05 ). The mean time of arthroscopic debridement was ( 9.54±2.019 ) min.Conclusions ( 1 ) Although longer operation time is needed due to the arthroscopy, it is more rigorous in selecting surgical indications;( 2 ) Arthroscopy is an essential method for the patients treated by UKA and with lesions in other compartments;( 3 ) For the patients with lesions in other compartments indicated by the preoperative imaging studies and examinations, arthroscopic debridement should be a routine step before UKA.