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Introduction: Unicompartmental knee replacement (UKR) is well-established procedure for the anteromedial compartment of knee arthritis with intact anterior cruciate ligament. The significance of age and body mass index (BMI) is not clear in the outcomes of UKR. Our hypothesis was that age and BMI does not affect the clinical and functional outcome following fixed bearing UKR., Materials and Methods: The study cohort of 148 was selected after stringent inclusion criteria and average followup was 5.6 years (range 2-10 years). The fixed bearing Miller Galante UKR procedure was carried out on all patients., Results: In the study cohort of 175, the average age of the cohort was 61.7 years. The sample size aged ≤55 years and aged ≥55 years was 38 and 137, respectively. The mean BMI of the cohort was 29.2 kg/m 2 (range: 21-38 kg/m 2 ). The sample size of BMI ≤30 kg/m 2 and BMI ≥30 kg/m 2 was 117 and 58, respectively. In the cohort group, BMI ≤30 kg/m 2 and BMI ≥30 kg/m 2 , there was no statistically significant difference in the Knee Society Score clinical scores, functional scores, and knee range of motion scores, ( P > 0.05). This study infers no statistically significant difference in the clinical and functional outcome between age group ≤55 years and age ≥55 years, ( P > 0.05). The failure rates of the group of BMI ≤30 kg/m 2 and BMI ≥30 kg/m 2 were 4.27% (5 knees) 3.44% (2 knees), respectively. The failure rates in the age group ≤55 years and group ≥55 years were 2 knees (3.44%) and 5 knees (4.27%), respectively., Conclusion: This study confirms that age and BMI does not influence the functional outcome and clinical outcome following fixed bearing UKR., Competing Interests: There are no conflicts of interest.

Background: The purpose of this study is to analyse and report the mid-term results of 175 unicompartmental knee replacement (UKR) procedures performed for medial compartment knee arthritis from January 2001 to January 2010., Materials and Methods: The cohort participants were selected after stringent inclusion criteria and the average follow-up was 5.6 years (range 2-10 years). The fixed-bearing UKR procedure was carried out on all patients., Results: The pre-operative mean knee range of movement improved from 100° ± 11.3° to 118.3° ± 12° (p value <0.001). The pre-operative mean Knee Society (KS) knee and functional score improved from 47 ± 5.5 and 55.1 ± 4.6 to 91.8 ± 9.2 and 92 ± 10.1 (p value <0.001), respectively. The revision rate of the cohort was 4 % (seven knees) and implant survival rate was 96 % at the end of 10 years; 87 % of the cohort were satisfied with the procedure and had a normal gait pattern. In this study, there was no statistical difference between groups with a body mass index (BMI) ≤30 kg/m(2) and those with a BMI ≥30 kg/m(2), and between groups aged ≤55 years and those aged ≥55 years, in clinical and functional outcome following UKR., Conclusion: This study confirms that fixed-bearing UKR gives excellent results in patients with medial compartment knee arthritis who comply with the inclusion criteria. Age and BMI were not considered to influence the clinical and functional outcomes. Level of evidence-III., Competing Interests: None of the authors have received any grants or funding and do not have any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Ethical standards Obtaining the informed consent from involved patients was waived by the Research Ethics Committee. All procedures involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments. The study was approved by the Research Ethics Committee.

Background: Ten to fifteen percent of knee arthritis is reported to be isolated patellofemoral arthritis. Total knee arthroplasty is not recommended for isolated patella femoral arthritis particularly in young patients. We present the retrospective review of 45 consecutive patellofemoral replacements performed in 41 such patients, between June 2002 and January 2007., Materials and Methods: All patients were operated by single surgeon (SM) or under his supervision. All forty five patients had minimum three year followup and had the data collected prospectively. No patient was lost to followup. This data was later collated by review of notes, radiographs, and a clinical followup. The patients were assessed using knee function score and Melbourne patellofemoral score., Results: The average followup was 4.5 years. The preoperative average Melbourne (Bartlett) score was 10 (range 5-21). Preoperative knee functional score averaged 57 (range 23-95). The average range of movement was 116° (range 100°-140°). Postoperatively, the average Melbourne knee score improved to 25 (range 11-30), while the knee function score was 85 (range 28 - 100). The difference was statistically significant (P<0.05). Eighty-five percent rated the result as good or excellent, while 12% rated it as fair. Five percent thought the result was poor. The most common complaint was clicking at 40° of flexion (n=7). Six patients underwent arthroscopic lateral release, which improved the symptoms in four patients. Two knees were revised one due to progression of tibiofemoral arthritis and the other due to persistent clicking, yielding a survival rate of 95.6% at an average five year followup., Conclusion: The Avon patellofemoral joint replacement provides predictably good results and excellent survivorship in the medium term, for isolated patellofemoral arthritis. However, progression of tibiofemoral arthritis remains unpredictable and therefore patient selection is crucial to ensure success. Clicking remains a potential problem and can compromise the postoperative results in upto 15% of the cases.

Patellar clunk syndrome is characterised by the formation of a fibrous nodule at the articular side of junction of superior pole of patella and the quadriceps tendon. Until now, it is only described in posterior cruciate substituting total knee replacements. We report the patellar clunk syndrome in a lady with patellofemoral joint replacement.