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Introduction Unicompartmental knee arthroplasty (UKA) is a treatment option in patients with unicompartmental degenerative disease. Compared to total knee arthroplasty (TKA), the advantages of UKA include accelerated recovery and cruciate ligament retention. These advantages, along with emerging evidence that mild patellofemoral joint osteoarthritis does not compromise results of UKA have encouraged expansion of the indications for UKA. Symptomatic lateral patellofemoral joint degenerative disease is a common cause of UKA revision. Partial lateral patellar facetectomy can provide relief from symptoms of lateral patellofemoral degenerative disease. We hypothesize that simultaneous UKA and lateral patellar facetectomy provides durable pain relief and functional improvement in a patient population with degenerative disease of one tibiofemoral compartment and the lateral patellofemoral joint. Materials and methods: Between 2004 and 2008, 11 lateral UKA's were performed in association with partial lateral patellar facetectomy in 11 female patients (mean age: 66.7 years) with degenerative changes in one tibiofemoral compartment and the lateral patellofemoral joint. Patients were followed clinically and radiographically for a mean of 5 years. Results No patient underwent revision surgery in the followup period. The mean international Knee Society (IKS) knee score improved from 64.9 ± 11.2 points preoperatively to 87.5 ± 12.6 points at final follow-up (p = 0.01). The mean IKS functional score improved from 65.9 ± 23.5 points preoperatively to 83.2 ± 23.3 points at final follow-up (p = 0.012). The mean Kujala score was 84.3 ± 13.5 points postoperatively. Progression of patellofemoral OA was observed in one patient. Conclusion Simultaneous UKA and partial lateral patellar facetectomy is a viable treatment option for symptomatic degenerative disease involving one tibiofemoral compartment and the lateral patellofemoral joint. This treatment approach may be a useful alternative to TKA or bicompartmental arthroplasty in a carefully selected patient population. Level of evidence Case series—Level IV. Magnussen RA, Gancel E, Servien E, Jacobi M, Demey G, Neyret P, Lustig S. Simultaneous Unicompartmental Knee Arthroplasty and Lateral Patellar Facetectomy for Bicompartmental Degenerative Disease. The Duke Orthop J 2013;3(1):61-66.

The success of posterior cruciate ligament (PCL) reconstruction is dependent on appropriate tunnel placement. Computed tomography (CT) provides detailed images of intra-articular osseous anatomy. The objective of this study was to analyze by CT the position of femoral and tibial tunnels relative to intra-operative goals following arthroscopic-assisted PCL reconstruction. Nineteen patients who underwent single-bundle PCL reconstruction were evaluated 16 months post-operatively. Each underwent a CT scan and tunnel locations were identified in the coronal, sagittal, and axial planes. The coronal plane tibial tunnel location was within 5mm of the intra-operative goal (48% of the total tibial plateau width from the medial border of the plateau) in 16 patients (84%). The sagittal plane tibial tunnel location was within 5mm of the intra-operative goal (the middle of the posterior half of the retrospinal surface) in 14 patients (74%). In the sagittal plane, the femoral tunnel location was within 5mm of the intra-operative goal (10mm from in the distal articular margin of the medial femoral condyle) in 15 patients (79%). In the notch, the femoral tunnel was between 10:30 and 11:30 for left knees or between 12:30 and 1:30 for right knees (the intra-operative goal was 11 o'clock for left knees and 1 o'clock for right knees) in 18 patients (95%). Arthroscopic PCL reconstruction results in tunnel positions near intra-operative goals. Further work is necessary to define CT-specific criteria for the assessment of PCL tunnel position.