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The Knee Care Press

Weekly

Check your knowledge
on PKR indications (pain location)


Based on the available clinical evidence, many of the historic beliefs about PKR contraindications can be called into question. In this series we examine some of the most common misconceptions. This week: pain location.


Would you exclude a patient from PKR if they pointed to their pain being anterior/in the patella region, or over the lateral condyle?

Studies have shown that the perceived location of knee pain does not influence the outcome of an Oxford PKR 1-3 as long as the patient is suffering from AMOA.

According to Liddle et al. 1 there was no relationship between the pre-op location of pain and the outcome at 1 and 5 years. When comparing patients with medial pain with those complaining of pains elsewhere in the knee, they observed no difference in OKS, AKSS or pain scores at 1 or 5 years.1 Similarly, Hamilton et al. 3 showed that the pre-op location of pain did not influence outcome at 10 years either.

  1. Liddle, A. D., et al. “Preoperative pain location is a poor predictor of outcome after Oxford unicompartmental knee arthroplasty at 1 and 5 years.” Knee Surgery, Sports Traumatology, Arthroscopy 21.11 (2013): 2421-2426. Find the source here. 
  2. Beard, D. J., et al. “Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome.” The Journal of bone and joint surgery. British volume 89.12 (2007): 1602-1607. Find the source here.
  3. Hamilton, T. W., et al. “Anterior knee pain and evidence of osteoarthritis of the patellofemoral joint should not be considered contraindications to mobile-bearing unicompartmental knee arthroplasty: a 15-year follow-up.” The bone & joint journal 99.5 (2017): 632-639. Find the source here.

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