Development and Early Results of a New Patellofemoral Arthroplasty

Recently, patellofemoral arthroplasty has attracted increased interest as a salvage treatment for isolated patellofemoral arthritis. However, there are very few reports of the experience with modern generation patellofemoral arthroplasties. This investigation describes a collective experience of four centres reporting on the outcome in patients of the use of one patellofemoral arthroplasty device. There were 70 patients (79 knees) who had failed an extensive non-operative treatment regimen and/or various conventional alternative surgical treatments. At a mean follow-up of three years (range: 2-6 years), there were 66 knees that had Knee Society Scores greater than 80 points (84%). Seventy-one knees (90%) functioned without pain in daily activity and stair climbing. Symptomatic isolated patellofemoral arthritis was successfully treated with a patellofemoral arthroplasty in the short term. We are encouraged by these excellent early results and await longer follow-up.

Section: Patient Selection and Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patellofemoral arthroplasty: a multi-centre study with minimum 2-year follow-up

Leadbetter

Kolisek

Levitt

et al. 2008

“…Recently there has been renewed interest in PFA to treat isolated patellofemoral arthritis [1] not responding to nonoperative treatment. Newer designs have been introduced, but little is published about older designs.…”

Section: Introductionmentioning

confidence: 99%

Midterm clinical results of the Autocentric II patellofemoral prosthesis

Wagenberg

Speigner

Gosens

et al. 2009

We studied the outcome of patellofemoral arthroplasties using the Autocentric prosthesis implanted in our clinic between 1994 and 2004. New insight on indications and contraindications motivated us to find risk factors in the failure of this prosthesis. Twenty-four patients had surgery for patellofemoral arthritis not responding to exhaustive nonoperative measures. The mean age at the time of patellofemoral arthroplasty (PFA) was 63.4 (SD 11.3, range 38-81) years with a mean follow-up of 4.8 (SD 2.9, range 2-11) years. Additional interventions were necessary in 21 knees during follow-up in our population, and seven knees required total knee arthroplasty (TKA) mainly due to progressive tibiofemoral osteoarthritis and maltracking of the patella. The patient outcomes and quality of life scores showed disappointing results, even after revision to TKA. This retrospective analysis underlines the importance of strict indications for patellofemoral arthroplasty and, in particular, of contraindications.

“…Similar problems were also reported after seven years with the Lubinus prosthesis [17,23,24], which is also sculpted into the trochlea. More recently, the Bristol Knee Group [1] reported a 96 % five-year survivorship of the first 100 Avon patello-femoral arthroplasties, with excellent pain relief, although inevitably some problems have been noted perhaps because the design resects a variable amount from the notch and has a symmetrical design. More recently, a variety of other prostheses (Leicester, Performance, and Journey) have been proposed aiming to address some of the persisting problems.…”

Section: Discussionmentioning

confidence: 99%

“…Recently there has been renewed interest in patello-femoral arthroplasty to treat isolated patellofemoral arthritis [1,4,5] not responding to non-operative treatment. Newer designs have been introduced, but little is published about these new designs.…”

Section: Discussionmentioning

confidence: 99%

Design, operative technique and ten-year results of the Hermes™ patellofemoral arthroplasty

Hernigou

Caton²

2013

Purpose Recently, increased interest has developed for patellofemoral arthroplasty as treatment for isolated patellofemoral arthritis. However, there are very few reports of the experience with the modern generation of patellofemoral arthroplasties. The new patellofemoral arthroplasty Hermes design is described. The design and technique of insertion are detailed. Methods The indications were isolated patellofemoral disease with advanced arthritic damage. Ten-year followup is available for treatment of 70 knees. Postoperative radiographs of patients were assessed for Oxford deterioration and maltracking of the patella. Tracking was categorised as follows: normal tracking, patellar subluxation, patellar dislocation. Results There were no late complications attributable to the arthroplasty. Disease progression in the tibiofemoral joint occurred in five patients requiring revision in three of these patients. Persistent anterior knee pain was recorded in four knees. The long-term results using this new design were better than those in the literature that described earlier designs, especially concerning malalignment. Only four knees in four patients had slight lateral patellar subluxation. Conclusions This implant offers a reasonable alternative to total knee replacement in patients with isolated patellofemoral disease.