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Pathology & Pathology & Biomechanics of Biomechanics of
Unicompartmental Unicompartmental ArthritisArthritis
John GoodfellowJohn GoodfellowNuffield Orthopaedic Centre, Oxford
Typical cases
• Antero-medial OA
• Functionally intact ACL
PosteriorPosteriorPosterior
Anterior
Anterior
Anterior
Preserved Cartilage
LostCartilage& Bone
Antero-medial OA
Varus deformitycorrects in
flexion
Medial collateralligament
tightPreventsligament
shortening
Loss of cartilage & bone
Varus deformity
Medial collateralligament
lax
Antero-medial OA
Varus deformitycorrects in
flexion
Medial collateralligament
tightPreventsligament
shortening
CorrectableVarus
Deformity
ACLIntact
ACL rupture
Loss of cartilage & bone
Posteriorly
Medial collateralligament
lax
Varus deformitypersists in
flexion
Medial collateralligament
laxMCL short
Fixed deformity
Anteromedial Osteoarthritis
• Cartilage loss limited to ANTERIOR TIBIAL PLATEAU
INFERIOR FEMORAL CONDYLE
• ACL INTACT
• CORRECTABLE VARUS DEFORMITY
Lateral X-ray
ANTERIOR
Posterior extent of cartilage loss correlates with the state of the ACL
ACL+
ACL+
ACL-Gross(sublux)
ACL?