Partial knee arthroplasty: patellofemoral arthroplasty and combined unicompartmental and patellofemoral arthroplasty implants – general considerations and indications, technique and clinical experience

Benazzo, Francesco; Rossi, Stefano Marco Paolo; Ghiara, Matteo

doi:10.1016/s0968-0160(14)50009-9

Cited by 26 publications

(20 citation statements)

References 9 publications

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“…This suggests that patellofemoral osteoarthritis may not be a contraindication of medial UKA. There was an argument that although the state of the patellofemoral joint does not affect the outcome of patients undergoing UKA, lateral patellofemoral osteoarthritis should still be regarded as a contraindication of UKA [23]. Our study found that moderate lateral PFOA had no significant effect on the mid-term follow-up of patients undergoing UKA.…”

Section: Discussioncontrasting

confidence: 45%

Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis

Yan

Wang

et al. 2020

J Orthop Surg Res

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Purpose The argument that patellofemoral osteoarthritis (PFOA) is a contraindication to unicompartmental knee arthroplasty (UKA) remains to be resolved. The purpose of this study was to perform a meta-analysis to determine whether PFOA affects functional outcomes and survivorship after medial UKA. Methods A literature search was performed in PubMed, Medline, Cochrane Library and Web of science to identify studies published in English (the last search was updated on June 1, 2020). The primary outcome measure was the Oxford Knee Score (OKS), whereas the secondary outcomes included range of motion (ROM) and the revision rate. Patients with patellofemoral joint narrowing or cartilage lesions as assessed intraoperatively or by radiography were assigned to the PFOA group. Results A total of 8 studies involving 3504 patients and 3975 knees were included in this meta-analysis. No patients had a severe lateral patellar groove. The results showed that there was no significant difference in the OKS, revision rate and ROM between PFOA patients and patients without PFOA. Conclusions No significant difference in functional outcomes and survivorship was found between patients with and without PFOA. Patients with PFOA assessed by radiographs or intraoperatively but without a lateral patellar groove should be considered candidates for medial UKA.

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Section: Discussioncontrasting

confidence: 45%

Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis

Yan

Wang

et al. 2020

J Orthop Surg Res

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“…A knee arthroplasty (KA) is a reliable and suitable surgical procedure for end-stage OA patients to relieve pain, to recover function and to improve health related quality of life 3 . With the creative designs and improved skills, we are now entering a new phase in which partial osteoarthritic changes can be treated with partial resurfacing prosthetic solutions such as unicompartmental, bi-unicompartmental or patellofemoral arthroplasty 4 . However, no matter what type of KA is performed, this surgery has commonly been associated with severe postoperative pain as well as postoperative nausea and vomiting (PONV).…”

Section: Introductionmentioning

confidence: 99%

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

Deng

Storm

et al. 2019

Sci Rep

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Steroids are frequently used for postoperative pain relief without definite evidence. This study was conducted to assess the pain management effect of the addition of steroids to a multimodal cocktail periarticular injection (MCPI) in patients undergoing knee arthroplasty and evaluate their safety. Pubmed, Embase, and Cochrane Library were searched through April, 2018. A total of 918 patients from ten randomized controlled trials (RCTs) were ultimately included. Compared with placebo groups, steroids application could effectively relieve pain on postoperative day (POD)1; decrease C-Reactive protein (CRP) level on POD3; improve range of motion (ROM) in postoperative 5 days; reduce morphine consumption, achieve earlier straight leg raising (SLR), and shorten the length of stay (LOS) in hospital. With regards to adverse effects, it did not increase the risk of postoperative infection, postoperative nausea and vomiting (PONV), or other complications. However, no significant difference in pain relief, ROM, or increased Knee Society Knee Function Scores were found during long-term follow up. Overall, this meta-analysis ensured the efficiency and safety of steroids with MCPI in knee arthroplasty patients during the early postoperative period.

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“…Unfortunately, despite the clear advantages of these "small implants" in terms of less-invasive surgery, even in 60-year-old non-obese patients with unicompartmental knee arthritis, some authors still feel TKA as the most reliable procedure. 12 It is reported that the rate of early postoperative complications is higher for PF arthroplasty than for TKA. 13 Early postoperative complications include persistent anterior knee pain, patellar catching or snapping, and extensor mechanism rupture.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, despite the clear advantages of these “small implants” in terms of less-invasive surgery, even in 60-year-old non-obese patients with unicompartmental knee arthritis, some authors still feel TKA as the most reliable procedure. 12…”

Section: Discussionmentioning

confidence: 99%

Patellofemoral Joint Arthroplasty: Our Experience in Isolated Patellofemoral and Bicompartmental Arthritic Knees

Sabatini

Schirò²,

Atzori³

et al. 2016

Clin Med�Insights�Arthritis�Musculoskelet Disord

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INTRODUCTIONIsolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments. The improvement in implant designs and surgical techniques has allowed the addition of a monocompartmental arthroplasty for the medial or lateral tibiofemoral compartment. In this work, we evaluate our first experience with PF arthroplasty and its combination with unicompartmental knee arthroplasty.MATERIALS AND METHODSFrom May 2014 to March 2016, we treated 14 patients. An isolated PF arthroplasty was performed in six knees (five patients), and a combined PF and unicompartmental knee arthroplasty was performed in nine cases. We observed a significant improvement in the clinical and functional Knee Society Scores (KSSs) after surgery in our patients.RESULTSWe obtained good results in our cases both for clinical and functional KSSs. Patellar clunk was recorded in one case.DISCUSSION AND CONCLUSIONWe are going toward a new attitude in which partial osteoarthritic changes could be treated with partial resurfacing prosthetic solutions such as unicompartmental, bi–unicompartmental or PFR alone, or unicompartmental combined, which respects the cruciates and achieves maximal bone preservation, which is vital, particularly, for young patients.

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Partial knee arthroplasty: patellofemoral arthroplasty and combined unicompartmental and patellofemoral arthroplasty implants – general considerations and indications, technique and clinical experience

Cited by 26 publications

References 9 publications

Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis

Does patellofemoral osteoarthritis affect functional outcomes and survivorship after medial unicompartmental knee arthroplasty? A meta-analysis

The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials

Patellofemoral Joint Arthroplasty: Our Experience in Isolated Patellofemoral and Bicompartmental Arthritic Knees

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