Pathology & Biomechanics of Unicompartmental Arthritis John Goodfellow Nuffield Orthopaedic Centre, Oxford.

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Presentation transcript:

Pathology & Biomechanics of Unicompartmental Arthritis John Goodfellow Nuffield Orthopaedic Centre, Oxford

Extreme case

Typical cases Antero-medial OA Functionally intact ACL Posterior Anterior

Preserved Cartilage Lost Cartilage & Bone Antero-medial OA

Preserved Cartilage Lost Cartilage & Bone Antero-medial OA Varus deformity corrects in flexion Medial collateral ligament tight Prevents ligament shortening Loss of cartilage & bone Varus deformity Medial collateral ligament lax

Antero-medial OA Varus deformity corrects in flexion Medial collateral ligament tight Prevents ligament shortening Correctable Varus Deformity

ACL Intact ACL rupture Loss of cartilage & bone Posteriorly Medial collateral ligament lax Varus deformity persists in flexion Medial collateral ligament lax MCL short Fixed deformity

Extreme case

Deformity corrects in flexion Bone preserved posteriorly

Deformity corrects with stress

Anteromedial Osteoarthritis Cartilage loss limited to ANTERIOR TIBIAL PLATEAU INFERIOR FEMORAL CONDYLE ACL INTACT CORRECTABLE VARUS DEFORMITY

Varus Valgus

Lateral X-ray ANTERIORANTERIOR Posterior extent of cartilage loss correlates with the state of the ACL ACL+ ACL- Gross (sublux) ACL?

Anteromedial Osteoarthritis

Thank you

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