OUKA is contraindicated in the inflammatory forms of arthritis because they are diseases of the synovium and therefore cannot be limited to one compartment. Therefore, if an OUKA is implanted, progression of the disease to the other compartments is likely to occur. However, the loss of cartilage in early rheumatoid arthritis can be unicompartmental and has been mistaken for anteromedial OA and treated by OUKA (Kumar & Fiddian, 1999). The clinician needs to be aware of this pitfall because it results in early failure due to involvement of the other compartments of the knee.
With the widespread use of disease modifying drugs in inflammatory arthritis, the role of OUKA may change. It may be that it will be appropriate to use an OUKA in a patient with well controlled inflammatory arthritis. However, until there is evidence to support this, we do not recommend it.
