The Avon patellofemoral joint replacement

Abstract

We present a prospective review of the two-year functional outcome of 37 Avon patellofemoral joint replacements carried out in 29 patients with a mean age of 66 years (30 to 82) between October 2002 and March 2007. No patients were lost to follow-up. This is the first independent assessment of this prosthesis using both subjective and objective analysis of outcome. At two years the median Oxford knee score was 39 (interquartile range 32 to 44), the median American Knee Society objective score was 95 (interquartile range 90 to 100), the median American Knee Society functional score was 85 (interquartile range 60 to 100), and the median Melbourne Knee score was 28 (interquartile range 21 to 30). Two patients underwent further surgery. Only one patient reported an unsatisfactory outcome. We conclude that the promising early results observed by the designing centre are reproducible and provide further support for the role of patellofemoral joint replacement.

The Warwick patellofemoral arthroplasty trial: a randomised clinical trial of total knee arthroplasty versus patellofemoral arthroplasty in patients with severe arthritis of the patellofemoral joint

“…These findings substantiate those of an earlier retrospective consecutive case study, where good or excellent functional results were reported, using the Knee Society Score (KSS), in 86% of 'residual' cases at 17 years [6]. Most recently, Odumenya et al [7] and Stark et al [8] have reported excellent functional outcomes with 100% survivorship at 5 and 2 years follow-up, respectively. Therefore, there is some evidence to suggest that PFA provides positive results for patients with isolated patellofemoral arthritis.…”

Medium term results of Avon patellofemoral joint replacement

“…Twelve (22%) patients in our series had previous operations on the same knee, which was similar to that reported in other series 92426. Out of these, six knees had previous lateral release performed, while others had chondrectomy earlier for patellar cartilage degeneration.…”

“…The Avon prosthesis is the only patellofemoral prosthesis with more than 1000 cases having five-year or longer follow-up, according to the National Joint Registry Report 2010 (UK) 25. However, most of the long-term results have been published by the designers,59 with good short-term results being reported by other centers only recently 2426. We present a large series with a longer followup.…”

Patellofemoral Arthroplasty: A Systematic Review of the Literature

“…1 ). The search identified 14 eligible studies reporting results from PFA [15-28] and 3 studies reporting results from TKA [29-31] in the treatment of isolated PFOA. There are no published randomised controlled trials comparing PFA to TKA for isolated patellofemoral arthritis, although one has been proposed [36].…”

“…There were several studies that were identified in the literature which had good numbers and sound methodology however the primary pre-operative diagnosis was not restricted to PFOA [38,39]. One particular study by Starks [28] and colleagues reported results of the Avon PFA and give an excellent independent verdict of the prosthesis, however, within their population they included one patient who had had a failed autologous chondrocyte implantation of the patella. As the pathology of this condition is limited to the patellofemoral joint and as it was an isolated case, its impact on the overall study was deemed to be small and hence it was included in this review.…”