Long-Term Results with the First Patellofemoral Prosthesis

A 21 % conversion rate to total knee arthroplasty of a first-generation patellofemoral prosthesis at a mean follow-up of 9.7 years (range, 110-200). Median VAS Pain was 30 (range, 0-80) and VAS Satisfaction median was 90 (range, 50-100). Thirteen (62 %) PFAs were rated excellent, six (28 %) as good and two (10 %) as fair. Twelve (36 %) of the cases required further surgery within 4 years after implantation. Seven of these (21 %) were converted to TKA after a mean time of 5.5 years, five out of seven were converted because of ongoing tibiofemoral osteoarthritis (TFOA).Conclusions We found a rate of 21 % (7/33) conversion of the Richards' II PFA to TKA after a mean of 5.5 years; 71 % (5/7) of cases were because of TFOA. We strongly advise not to use PFA if there is any sign of joint disease in other compartments than patellofemoral.

Section: Discussionsupporting

confidence: 75%

A 21 % conversion rate to total knee arthroplasty of a first-generation patellofemoral prosthesis at a mean follow-up of 9.7 years

Hoogervorst

Jong²,

Hannink

et al. 2015

“…However, while Ackroyd et al noted a 20% radiological progression of arthritis, the revision rate to TKA at five years or greater with the same prosthesis as that used in this study was only 4% of knees at time of follow-up [2]. Cartier et al reported a survivorship of 75% at six to ten years with the first-generation Richards I/II prosthesis [5]. The need for revision was primarily tibiofemoral disease progression, uncorrected extensor malalignment or technical error.…”

Section: Discussionmentioning

confidence: 57%

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

Leadbetter

Kolisek

Levitt

et al. 2008

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.

“…Success rates of PFA as described in English literature vary from 42% to 90% [4,[10][11][12]. The limited data published and varying indications used in these studies possibly explain the diversity of these rates.…”

Section: Discussionmentioning

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.