The Kozinn & Scott Myth: Can We Ignore Kneecap Arthritis in UKA?
New data proves that pre-existing patellofemoral osteoarthritis does not negatively impact outcomes in medial fixed-bearing partial knees.
Unicompartmental knee arthroplasty (UKA) is an attractive treatment option for unicompartmental osteoarthritis (OA) due to preservation of cruciate ligaments and bone stock, expedited recovery, reduced blood loss, and fewer complications compared to other surgical interventions. However, the decision of who is a good candidate for this procedure has been heavily influenced by historical guidelines.
In 1989, criteria were developed by Kozinn and Scott to guide surgeons with patient selection for UKA. Since its introduction, pre-existing patellofemoral arthropathy has been widely considered a contraindication by many surgeons. This means that for decades, if a patient had arthritis under their kneecap (the patellofemoral joint), they were typically disqualified from receiving a partial knee replacement and steered toward a total knee replacement instead.
More recently, some studies have argued that patellofemoral disease can be ignored in UKA; however, this supporting research is predominantly in mobile-bearing designs. We wanted to evaluate the effect of patellofemoral OA severity on the latest outcomes after fixed-bearing medial UKA.
