Patellofemoral arthroplasty: Current concepts

Cuthbert, Rory; Tibrewal, Saket

doi:10.1016/j.jcot.2017.11.006

Cited by 19 publications

(24 citation statements)

References 40 publications

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“…2017, Cuthbert et al. 2018). We encourage thorough clinical and imaging investigations preoperatively, and stress radiography, specialized radiographic projections, and MRI should be considered to ensure the absence of TF-OA.…”

Section: Discussionmentioning

confidence: 99%

Failure modes of patellofemoral arthroplasty—registries vs. clinical studies: a systematic review

2019

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Background and purpose — Patellofemoral arthroplasty (PFA) has been debated since early studies showed poor implant survival. Recent studies show better results. This review reports failure modes for PFA and investigates differences in data reported from registries and clinical studies. Additionally, we report differences in failure modes among implant designs.Methods — A systematic search was performed in September 2018. All studies and registers describing failure modes of PFA were included and implant design was noted for each revision.Results — This review includes 1,299 revisions of a primary PFA reported in 47 clinical studies and 3 registers. The failure modes were: 42% OA progression, 16% pain, 13% aseptic loosening, 12% surgical error, 4% wear, 2% infection, 2% broken patellar component, 1% stiffness, 1% fracture, and 7% other. The data from registries and cohort studies differed statistically significantly in 7 out of 12 failure modes. Significant differences were found in several failure modes among implant designs.Interpretation — OA progression is the most common failure mode of PFA. There are significant differences in data on failure modes between registers and protocolled studies, notably for surgical error. The implant design significantly influences several of the failure modes. In conclusion, indication, surgical technique, and implant design are important for a successful PFA, and register-based failure modes should be interpreted with caution.

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Section: Discussionmentioning

confidence: 99%

Failure modes of patellofemoral arthroplasty—registries vs. clinical studies: a systematic review

2019

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“…Additional reports of the McKeever prosthesis were promising, but issues related to the differential hardness of the prosthesis vs the native femoral groove were identified [ 11 ]. Subsequently, polyethylene prostheses were developed for isolated resurfacing, but long-term results were also unsatisfactory because of erosion of the femoral trochlear groove [ 2 , 4 , 5 ]. First generation inlay patellofemoral arthroplasty, developed in 1979, involved resurfacing of both the patella and the trochlear groove.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, the metal prosthesis was fabricated from vitallium, as described by McKeever [ 1 ]. The long-term results of isolated patellar resurfacing with a polyethylene component have sparsely been studied, with favorable short-term patient satisfaction, but poor long-term outcomes [ 2 , 4 , 5 ]. Most commonly, failure was related to wearing of the cortical bone in the femoral trochlear groove, which led to the development of a metallic trochlear component to articulate with the patella, the modern-day patellofemoral arthroplasty [ 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Tibial Osteolysis After Long-Term Isolated Polyethylene Patellar Resurfacing

2021

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Isolated patellar resurfacing served as an early treatment for patellofemoral arthritis but was abandoned because of erosion of the native femoral trochlear groove over time. We present the case of a large native tibial osteolytic lesion 20 years after isolated patellar resurfacing with a cemented polyethylene component. The patient had severe tricompartmental arthritic changes. The patellar component was very worn, and the resultant particle debris produced a large cavitary lesion in the proximal tibia. Osteolysis is a rare complication in patellofemoral arthroplasty, and, to our knowledge, this is the first reported case of native tibial osteolysis after isolated patellar resurfacing. The patient was treated with initial curettage and bone grafting of the lesion followed by total knee arthroplasty with a tibial cone and stemmed tibial fixation.

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“…The 71.4% of our knee arthroplasty were small implants (UKA or PFJ arthroplasty). It is well known that the choice of “small implants” reduces operating time as well as intraoperative and postoperative bleeding [23–26]. Moreover, all knee arthroplasties were performed without tourniquet and with a “free-hand” technique, without using instrumentations and cutting guides, reducing, in this manner, operating time and intraoperative-postoperative bleeding [27, 28], as well as invasiveness on the bone tissue avoiding femoral and tibial intramedullary canal violation.…”

Section: Discussionmentioning

confidence: 99%

One-staged combined hip and knee arthroplasty: retrospective comparative study at mid-term follow-up

et al. 2019

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Background To date, few knowledge is available about safety and effectiveness of one-staged combined hip and knee arthroplasty. The aim of our study was to evaluate, in a comparative fashion, complications and outcomes in patients who underwent one-staged hip and knee arthroplasty. Methods Forty-two patients were enrolled and allocated into two groups of 21 patients each: one-staged hip and knee arthroplasty (group A) and two-staged hip and knee arthroplasty (group B). The follow-up averaged 50.2 months. Postoperative complications and implant survivorship were assessed prospectively. Outcomes were evaluated with Harris Hip score (HSS), Western Ontario Mc-Ministry score for the hip (h-WOMAC), Knee Society score (KSS), and Western Ontario Mc-Ministry knee score (k-WOMAC). Hip and knee range of motion (ROM) were measured both preoperatively and at the last follow-up. Results Two (9.5%) patients in group A and three (14.3%) patients in group B developed complications ( P = 0.8). Although a significant decrease in postoperative haemoglobin (Hgb) values was found in group A patients during the hospital stay, no differences in blood transfusions were found ( P = 0.8). No significant differences were found comparing clinical-functional outcomes between the two groups, while a significant reduction of hospital length of stay was shown in group A patients. Conclusions One-staged combined hip and knee arthroplasty could be considered in patients with co-existing severe hip and knee osteoarthritis, providing similar complications and mid-term outcomes of two-staged procedures. However, the reproducibility safety and reliability of these procedures should be confirmed in prospective comparative randomised trials with more numerous patients. Trial registration Retrospectively registered

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Patellofemoral arthroplasty: Current concepts

Cited by 19 publications

References 40 publications

Failure modes of patellofemoral arthroplasty—registries vs. clinical studies: a systematic review

Failure modes of patellofemoral arthroplasty—registries vs. clinical studies: a systematic review

Tibial Osteolysis After Long-Term Isolated Polyethylene Patellar Resurfacing

One-staged combined hip and knee arthroplasty: retrospective comparative study at mid-term follow-up

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