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Purpose: The pattern of symptoms of knee osteoarthritis has been thought to be indicative of specific compartment involvement. This study investigated whether there was a true correlation between patellofemoral joint (PFJ) symptoms and unicompartmental patellofemoral arthritis. Materials and Methods: A prospective analysis of 34 patients rendered to be suffering from PFJ osteoarthritis and subsequently undergoing unicompartmental patellofemoral arthroplasty (PFA) was performed. A control cohort of 32 patients suffering from medial tibiofemoral joint (MTFJ) osteoarthritis was included in the analysis. Four questions derived from the Oxford knee score questionnaire, traditionally deemed to be indicative of PFJ osteoarthritis, were combined to create a PFJ subscore and statistically analyzed for their potential relationship with PFJ osteoarthritis and outcomes following PFA. Results: The PFJ subscore indicated slightly worse pathology in patients undergoing PFA compared to MTFJ replacement, but the difference was not significant (9.7 and 9.6, respectively; p=0.851). The improvement in PFJ symptoms was higher in those undergoing PFA compared to MTFJ surgery; however, the difference was not statistically significant (3.7 and 2.2 respectively, p=0.074). Conclusions: We were unable to prove that these symptoms were predictive of PFJ pathology in the preoperative setting, nor were they useful in interpreting which symptoms would likely improve following PFA. [ABSTRACT FROM AUTHOR]

The objective assessment of outcome of surgical procedures is assuming increasing significance as the culture of audit and revalidation advances. There is a clear need for surgeons in all fields, but especially in Orthopaedics, to be familiar with the available scoring systems and their relative strengths and weaknesses. It is clear from a recent survey of BASK members’ practice that there is little consensus about which system to use (addendum). This review presents a summary of the scoring systems available for the assessment of patients undergoing total knee replacement. These scores are described in detail and their relative merits discussed. None of the systems reviewed is perfect but those developed most recently do appear to offer advantages over older systems. Overall, the Western Ontario and McMaster University Osteoarthritis Index, Short Form 36 and Oxford Knee Score have undergone the most thorough assessment of reliability and validity and are therefore appropriate for the assessment of outcome after total knee replacement. [Copyright &y& Elsevier]

Background: Unicompartmental patellofemoral arthroplasties are uncommon however numbers are increasing and there are a variety of new prostheses available. The Femoro-Patella Vialla (FPV, Wright Medical) device was the second most commonly used patellofemoral unicompartmental prosthesis in the 2012 British National Joint Register. There are however no published outcomes data for this device. Method: 52 consecutive cases were studied prospectively using Oxford Knee Score and American Knee Society Scores pre-operatively and at follow up to a minimum of two years. Results: Overall Oxford Knee Scores improved from 30 points pre-operatively (36.6%) to 19 points (60%) at one-year. American Knee Society Knee scores improved from 51 points pre-operatively to 81 points at one-year. Function scores improved from 42 points pre-operatively to 70 points at one-year. 13 (25%) patients had an excellent outcome with pain abolished and near normal knee function. 11 (21%) patients gained very little improvement and scored their knees similar or worse to their pre-operative state. There were no infective or thromboembolic complications. Seven cases have been revised to a total knee replacement for on-going pain in six cases and progression of arthritis in the tibio-femoral compartments in one case. The patellar button was found to be very poorly fixed in all cases that were revised. Conclusion: Early results with the FPV prosthesis demonstrate that successful outcomes can be achieved however the results were unpredictable and a significant minority of patients had on-going symptoms that they found unacceptable. The early revision rate was high in this series. [ABSTRACT FROM AUTHOR]