The Clinical Outcome of Patellofemoral Arthroplasty vs Total Knee Arthroplasty in Patients Younger Than 55 Years

Kamikovski, Ivan; Dobransky, Johanna; Dervin, Geoffrey F.

doi:10.1016/j.arth.2019.07.016

Cited by 25 publications

(34 citation statements)

References 22 publications

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“…Some studies have compared PFA and TKA patients, but they focused on only clinical outcomes and implant survivorship. 2,3,7 A few studies, however, investigated the difference in UCLA scores between PFA and TKA. Kamikovski et al 7 found no difference in UCLA scores between PFA and TKA patients.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,7 A few studies, however, investigated the difference in UCLA scores between PFA and TKA. Kamikovski et al 7 found no difference in UCLA scores between PFA and TKA patients. In contrast, Dahm et al 2 noted a significantly higher UCLA score after PFA than TKA, although that study did not match the groups on patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…Shubin Stein et al 21 found that 72.2% of patients were able to return to some level of activity, and >52% returned to the same level or higher. Kamikovski et al, 7 comparing patients who underwent TKA and PFA, found no difference in Tegner and University of California, Los Angeles (UCLA) scores between the 2 patient groups at 1 to 2 years of follow-up. No studies have directly compared PFA against TKA or UKA on return-to-sports outcomes in a comparable population.…”

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confidence: 99%

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Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort

Schneider

Ling

Kleebad

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Return to sports is an important outcome in ensuring patient satisfaction after knee-replacement surgery. However, few studies have directly compared unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and patellofemoral arthroplasty (PFA). Hypothesis: TKA will result in lower rates of return to sports than either UKA and PFA due to increased complexity and invasiveness. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent UKA, TKA, or PFA with 1 to 2 years of follow-up were sent a questionnaire regarding return to sports, satisfaction with return to sports, pain, the University of California, Los Angeles activity scale, and the High Activity Arthroplasty Score (HAAS). The patients who underwent either TKA or UKA were matched 2:1 with regard to age and sex to patients who underwent PFA. Differences were compared using analysis of variance, t tests, and chi-square tests. Results: A total of 202 patients were eligible. After matching, the final cohort consisted of 23 PFA patients, 46 UKA patients, and 46 TKA patients. The majority of patients were female (87%), and the mean ± SD age was 56 ± 9.1 years. The UKA group had higher HAAS values than the TKA group pre- and postoperatively (9.9 vs 7.1 [ P = .001] and 12.4 vs 9.5 [ P < .001], respectively). Patients with UKA had higher rates of return to sports after surgery than those with TKA or PFA (UKA, 80.5%; TKA, 71.7%; PFA, 69.5%; P = 0.08). In addition, the UKA group had the highest satisfaction with this outcome. Improvement between pre- and postoperative scores was similar in all 3 groups. Conclusion: Patients who underwent UKA reported better activity scores and return-to-sports rates than patients who had TKA and PFA. No differences were found in improvement after surgery, suggesting that preoperative differences were reflected postoperatively. These findings inform shared decision making and can help to manage patient expectations after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort

Schneider

Ling

Kleebad

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…The pathological factors of patellofemoral articular degeneration are various. Besides the joint diseases related to aging and trauma, trochlear dysplasia is also an inducing factor 6 . Femoral anteversion and patellar instability also aggravate the progress of PFOA 7 .…”

Section: Introductionmentioning

confidence: 99%

Joint Awareness after Patellofemoral Arthroplasty Evaluated with the Forgotten Joint Score: A Comparison Study

Lin

Dai

Dong

et al. 2021

Orthopaedic Surgery

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Objective The aim of the present study was to compare the forgotten joint score (FJS) in patients with isolated patellofemoral osteoarthritis who underwent patellofemoral arthroplasty (PFA) versus those who underwent total knee arthroplasty (TKA) and to analyze the predictors of the FJS after PFA. Methods From January 2014 to December 2017, a retrospective cohort study of 56 consecutive patients with isolated patellofemoral osteoarthritis underwent PFA and were included in the PFA group. The patients in the PFA group were matched in a 1:1 ratio based on age, sex, body mass index (BMI), and follow‐up duration; 56 patients with isolated patellofemoral osteoarthritis underwent cruciate‐retaining TKA (TKA group). The FJS, range of motion of the knee, and Knee Society Score were assessed at 1 and 3 years postoperatively. In addition, the associations between the potential influencing factors (age, sex, BMI, and preoperative Iwano score of the patellofemoral joint) and the FJS were analyzed using multiple linear regression in the PFA group. Results There were no significant differences between the PFA and TKA groups regarding age (P = 0.316), sex (P = 0.832), BMI (P = 0.447), and follow‐up duration (P = 0.625). Postoperatively, the range of motion of the knee and Knee Society Score was significantly higher in the PFA group than the TKA group at both follow‐up points (P < 0.05). The PFA group had a significantly higher mean FJS than the TKA group at 1 year postoperatively (62.9 ± 12.3 vs 54.1 ± 14.2, P = 0.034) and 3 years postoperatively (63.3 ± 14.1 vs 55.6 ± 16.4, P = 0.042). In the PFA group, multiple linear regression analysis showed that older age was positively correlated with the FJS, while a higher BMI was negatively correlated with the FJS. Conclusion The patients with isolated patellofemoral osteoarthritis who underwent PFA were more likely to forget the artificial joint and, consequently, may experience a higher degree of satisfaction. In addition, we identified two preoperative patient‐related factors (age and BMI) that may predict the FJS after PFA, which might help in chosing the most appropriate operation.

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“…The wear of endstage PFOA often involving femoral trochlea, patellar facet, or both. The pathological factors of patellofemoral articular degeneration are various, besides the joint diseases related to aging and trauma, trochlear dysplasia is also an inducing factor [5]. In addition, femoral anteversion and patellar instability also aggravate the progress of PFOA [6].…”

Section: Introductionmentioning

confidence: 99%

Good clinical outcomes of patellofemoral arthroplasty for isolated patellofemoral osteoarthritis: a case-matched cohort comparative study of PFA with TKA

Wang

Lin

Chen

et al. 2020

Preprint

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Background: Severe isolated patellofemoral osteoarthritis is usually treated by total knee arthroplasty (TKA) in the majority of the world but patellofemoral arthroplasty (PFA) has been a viable alternative for many years although there have been concerns about implant longevity. The purpose of this research was to compare the clinical outcome of patients with isolated patellofemoral osteoarthritis who received PFA or TKA. Methods: From January 2015 to December 2017, 42 patients with isolated patellofemoral osteoarthritis who received PFA were included in the PFA group. In this period, a matched cohort of 42 patients with isolated patellofemoral osteoarthritis who received TKA (TKA group) was chosen for comparison. The results of the two groups were compared before surgery and at last follow-up using Tegner Activity Scale, Range of motion of the knee, Oxford Knee Score and Short Form 36 Health Survey. Differences were considered statistically significant at p < 0.05.Results: The mean follow-up time was 3.5 ± 0.3 and 3.4 ± 0.3 years in the PFA and TKA groups (p = 0.13), respectively. No significant difference in preoperative knee scores were found between the two groups (p > 0.05). However, postoperative, compared with Tegner Activity Scale, Range of motion, Oxford Knee Score and Short Form 36 Health Survey, the PFA group performed significantly better results (p < 0.05). The Kaplan-Meier implant survivorship with 95% confidence intervals was 94.12 % in the PFA group and 94.74% in the TKA group (p = 0.49).Conclusions: The patients with isolated patellofemoral osteoarthritis who underwent PFA had shown better clinical outcomes and higher quality of life. We believed that for the treatment of isolated patellofemoral osteoarthritis, the PFA was a less invasive procedure with improved patient satisfaction and range of motion at medium term follow-up.

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The Clinical Outcome of Patellofemoral Arthroplasty vs Total Knee Arthroplasty in Patients Younger Than 55 Years

Cited by 25 publications

References 22 publications

Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort

Comparing Return to Sports After Patellofemoral and Knee Arthroplasty in an Age- and Sex-Matched Cohort

Joint Awareness after Patellofemoral Arthroplasty Evaluated with the Forgotten Joint Score: A Comparison Study

Good clinical outcomes of patellofemoral arthroplasty for isolated patellofemoral osteoarthritis: a case-matched cohort comparative study of PFA with TKA

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