Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis—a systematic review

Woon, Colin Yi-Loong; Christ, Alexander B.; Goto, Rie; Shanaghan, Kate; Stein, Beth E. Shubin; Valle, Alejandro González Della

doi:10.1007/s00264-018-04280-z

Cited by 18 publications

(12 citation statements)

References 56 publications

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“…While patellofemoral joint replacement is a more conservative option, a high failure rate with this prosthesis causes some concerns. 3,4 These concerns have led to some centres, including ours, undertaking total knee replacements for patients suffering with isolated patella femoral arthritis. [5][6][7][8] A prospective blinded randomised trial comparing the PFC (predecessor of Attune) and patellofemoral replacement in patients with patellofemoral arthritis found an improvement in the OKS of 10 with PFC and 15 19 We note that in our study we have used a posterior stabilised Attune implant as compared to a posterior cruciate retaining implant in above comparative study.…”

Section: Discussionmentioning

confidence: 99%

“…2 Severe isolated patellofemoral arthritis can be treated with total knee replacement. [3][4][5][6][7][8] Total knee replacement in general gives a good result but some patients continue to suffer from pain, patellofemoral crepitus and reduced range of movements, which limit their function. The origin of the pain or its contribution to functional limitation is difficult to understand but prosthesis design 9 and surgical errors including patellofemoral mal-tracking, patella tilt and over stuffing of the patellofemoral joint have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…2 Severe isolated patellofemoral arthritis can be treated with total knee replacement. 3 –8…”

Section: Introductionmentioning

confidence: 99%

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Has the modern design of Attune total knee replacement improved outcome in patients with isolated patellofemoral arthritis?

Ashraf

Iqbal

Senevirathana

et al. 2020

J Orthop Surg (Hong Kong)

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Introduction and Aim: Modern knee replacements aim to improve patient function in arthritis affecting different compartments of the knee. This study evaluates the Patient Reported Outcome Measure (PROM) and functional outcome of a modern total knee replacement (Attune, DePuy) in patients with isolated patellofemoral arthritis. Methods: A total of 50 consecutive patients with isolated unilateral patellofemoral arthritis having had Attune total knee replacements at a single institution between 2010 and 2016 were prospectively studied. Five patients who developed symptoms on the opposite side during the study and two patients lost to follow-up were excluded. One patient needed early revision for loosening, leaving a total of 42 patients to be followed up over a period of 4 years. The Oxford Knee score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) recorded pre-operatively and at follow-up was compared. A Functional assessment at around 8 months after operation was undertaken. Results: At average follow-up of 24 months the mean OKS score improved by 15 points and the KOOS score improved by 20 points. Final KOOS sub-score for Pain was 80, Symptom 80, and ADL 82, Sports & Recreation 32 and QOL 60. Functional assessment at mean 8 months showed that a significant number of patients were able to Kneel (50%); Sit cross legged (23%); sit on their heel (23%) and were able do a single leg dip test (86%). Conclusion: This unique study of a modern design total knee replacement (Attune) in patients with isolated unilateral patellofemoral arthritis shows good PROM scores at 2 years and good functional assessment results at 8 months. The PROM scores are marginally better than the published results with Attune’s predecessor, in a similar cohort of patients, but falls short of the published results of patellofemoral replacement implants. Large randomised comparative studies between traditional and the modern implant design is recommended to answer the question if design modification has influenced clinical outcome in patients with patellofemoral arthritis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Has the modern design of Attune total knee replacement improved outcome in patients with isolated patellofemoral arthritis?

Ashraf

Iqbal

Senevirathana

et al. 2020

J Orthop Surg (Hong Kong)

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“…8 Dissatisfying results of PFA implant survivorship might be the main reason. A systematic review of studies has revealed higher revision (8.4% vs. 1.3%) 9 and reoperation rate (9.1% vs. 3.7%) 10 for PFA against TKA in treatment of isolated patellofemoral arthritis, which might be related to the design pitfalls and longer learning curve of the first-generation inlay PFA prostheses.…”

Section: Introductionmentioning

confidence: 99%

Long-Term clinical results of patellofemoral arthroplasty for isolated patellofemoral osteoarthritis

Wang

Bian

Qian

2023

J Orthop Surg (Hong Kong)

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Objectives The aim of this study was to explore the clinical outcomes and long-term survival of patellofemoral arthroplasty in treatment of isolated patellofemoral osteoarthritis. Methods We retrospectively studied a total of 46 type Y-L-Q PFAs that were designed at our institution in 38 patients. Implant survivorship was analyzed with a follow-up of 18.9–29.6 years. Knee Society Score (KSS), Oxford Knee Score (OKS), and University of California Los Angeles activity scale (UCLA) were used to assess functional outcomes. Results The implant survivorship was 83.6% at 15 years, 76.8% at 20 years, and 59.4% at 25 years 14 PFAs in 12 patients were revised into total knee arthroplasty at 16.0 ± 6.7 years; 13 for progression of tibiofemoral osteoarthritis and one for polyethylene wear. The mean Knee Society Score objective scores and functional scores were 73.0 ± 17.5 (range, 49–95) and 56.4 ± 28.9 (range, 5–90), respectively. The mean Oxford Knee Score was 25.8 ± 11.5 (range, 8–44). Conclusion Type Y-L-Q patellofemoral arthroplasty can be an effective method for treating isolated patellofemoral osteoarthritis with satisfactory survival.

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“…In a recent randomized controlled trial comparing PFA and TKA for isolated patellofemoral OA, PFA resulted in better range of motion and better patient-reported outcome [44]. However, relatively high reoperation and revision rates remain an issue of debate [5,34,51,58]. Whereas implant design-specific complications were the main reasons for failure with early PFA designs, progression of tibiofemoral OA is considered the main failure mode of contemporary used implants [5,51].…”

Section: Introductionmentioning

confidence: 99%

Preoperative patellofemoral anatomy affects failure rate after isolated patellofemoral inlay arthroplasty

Feucht

Lutz

Ketzer

et al. 2020

Arch Orthop Trauma Surg

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Purpose To analyze whether preoperative patellofemoral anatomy is associated with clinical improvement and failure rate after isolated patellofemoral arthroplasty (PFA) using a modern inlay-type trochlear implant. Methods Prospectively collected 24 months data of patients treated with isolated inlay PFA (HemiCAP® Wave, Arthrosurface, Franklin, MA, USA) between 2009 and 2016, and available digitalized preoperative imaging (plain radiographs in three planes and MRI) were retrospectively analyzed. All patients were evaluated using the WOMAC score, Lysholm score, and VAS pain. Patients revised to TKA or not achieving the minimal clinically important difference (MCID) for the total WOMAC score or VAS pain were considered failures. Preoperative imaging was analyzed regarding the following aspects: Tibiofemoral OA, patellofemoral OA, trochlear dysplasia (Dejour classification), patellar height (Insall–Salvati index [ISI]; Patellotrochlear index [PTI]), and position of the tibial tuberosity (TT–TG and TT–PCL distance). Results A total of 41 patients (61% female) with a mean age of 48 ± 13 years could be included. Fifteen patients (37%) were considered failures, with 5 patients (12%) revised to TKA and 10 patients (24%) not achieving MCID for WOMAC total or VAS pain. Failures had a significantly higher ISI, and a significantly lower PTI. Furthermore, the proportion of patients with a pathologic ISI (> 1.2), a pathologic PTI (< 0.28), and without trochlear dysplasia were significantly higher in failures. Significantly greater improvements in clinical outcome scores were observed in patients with a higher preoperative grade of patellofemoral OA, ISI ≤ 1.2, PTI ≥ 0.28, TT–PCL distance ≤ 21 mm, and a dysplastic trochlea. Conclusion Preoperative patellofemoral anatomy is significantly associated with clinical improvement and failure rate after isolated inlay PFA. Less improvement and a higher failure rate must be expected in patients with patella alta (ISI > 1.2 and PTI < 0.28), absence of trochlear dysplasia, and a lateralized position of the tibial tuberosity (TT–PCL distance > 21 mm). Concomitant procedures such as tibial tuberosity transfer may, therefore, be considered in such patients. Level of evidence Level III, retrospective analysis of prospectively collected data.

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Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis—a systematic review

Cited by 18 publications

References 56 publications

Has the modern design of Attune total knee replacement improved outcome in patients with isolated patellofemoral arthritis?

Has the modern design of Attune total knee replacement improved outcome in patients with isolated patellofemoral arthritis?

Long-Term clinical results of patellofemoral arthroplasty for isolated patellofemoral osteoarthritis

Preoperative patellofemoral anatomy affects failure rate after isolated patellofemoral inlay arthroplasty

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