The midterm results of a cohort study of patellofemoral arthroplasty from a non-designer centre using an asymmetric trochlear prosthesis

Rammohan, R; Gupta, Shreekant; Lee, Paul Y F; Chandratreya, Amit

doi:10.1016/j.knee.2019.10.026

Cited by 5 publications

(8 citation statements)

References 25 publications

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“…In terms of OKS, 13 included studies, have reported improved postoperative scores, when compared to preoperative ones [1–4, 14, 19, 24, 32, 33, 36, 38, 42, 48]. No difference was observed between inlay and onlay implants, in terms of OKS [16].…”

Section: Resultsmentioning

confidence: 99%

“…Tegner score was reported by five studies [7, 12, 23, 30, 40]. Furthermore, Kujala score [42, 48, 50], Lysholm score [16, 42, 50], KOOS [1, 12, 38], SF‐12 and SF‐36 [1, 19, 38] UCLA [12, 30], MKS [19, 43], HKS [3], IKS [10], IKDC [23], AKP [10] and HSS‐PF [50] were also presented. A small difference in Lysholm score values between inlay and onlay designs has been reported at a median follow‐up period of 25.5 months (range not given), with the inlay group scoring slightly higher (66 ± 11 vs. 57 ± 22) [16].…”

Section: Resultsmentioning

confidence: 99%

“…In the case of reported complications, complication rates and implant survivorship, the present findings tend to exhibit a high degree of heterogeneity. In total, 19 studies were identified [1–3, 5, 7, 10, 19, 22, 24, 25, 30, 32, 36, 38, 40, 42, 43, 49, 50]. Complication rates varied greatly among analysed studies, from as low as 0.0% [25, 36] to as high as 35.3% [49] or even 41.2% [50].…”

Section: Resultsmentioning

confidence: 99%

“…Complication rates varied greatly among analysed studies, from as low as 0.0% [25, 36] to as high as 35.3% [49] or even 41.2% [50]. The most commonly reported complication was patellar maltracking, followed closely by anterior knee pain [1–3, 5, 7, 10, 19, 22, 24, 30, 32, 38, 42, 43, 49, 50]. Reported revision rates also exhibited an elevated degree of heterogeneity between them, with some studies stating low revision rates of 3.8% [42] or 3.9% [24], and others reporting high revision rates such as 50.0% [22] or even 55.0% [5].…”

Section: Resultsmentioning

confidence: 99%

“…Another weakness is the retrospective type of the majority of the included studies, which could have led to an unknown selection bias. Another important aspect is that there are no studies reporting at mid-and long-term follow ups regarding the new inlay type of prosthesis, meaning that safe conclusions, with regards to the clinical and functional [38] 16 HemiCap Wave 24.1 (6-34) 1 (6.3%) 0 (0.0%) Metcalfe [32] 558 Avon 180 (nm) 61 (10.9%) 61 (10.9%) Ajnin [2] 43 FPV 65 (30-119) 5 (11.6%) 6 (13.9%) Bohu [10] 30 Hermes 240 (nm) 9 (30.0%) 9 (30.0%) Imhoff [22] 24 HemiCap Wave 60 (nm) 0 (0.0%) 6 (25.0%) Rammohan [42] 103 Journey 60 (± 12, 24-108) 9 (8.7%) 2 (1.9%) Bernard [7] 153 Avon 60 (± 30) 9 (5.9%) 9 (5.9%) Pogorzelski [40] 62 HemiCap Wave 60 (± 25) 12 (19.4%) 12 (19.4%) Marullo [30] 120 Gender Solutions 84 (± 30, 24-142) 5 (4.2%) 1 (0.8%) outcomes, and the survivorship of this type of prosthesis should be drawn with all due caution. Lastly, many authors were consultants for the companies designing the type of prostheses investigated in the respective studies, which might have led to a conflict of interest.…”

Section: Discussionmentioning

confidence: 99%

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Patellofemoral arthroplasty with onlay prosthesis leads to higher rates of osteoarthritis progression than inlay design implants: a systematic review

Sava

Neopoulos

Leica

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this study was to report the clinical and functional outcomes, complication rates, implant survivorship and the progression of tibiofemoral osteoarthritis (OA), after new inlay or onlay patellofemoral arthroplasty (PFA), for isolated patellofemoral OA. Comparison of different implant types and models, where it was possible, also represented one of the objectives. Methods A systematic literature search following PRISMA guidelines was conducted on PubMed, Scopus, Embase and Cochrane databases, to identify possible relevant studies, published from the inception of these databases until 11.11.2022. Randomized control trials (RCTs), case series, case control studies and cohort studies, written in English or German, and published in peer-reviewed journals after 2010, were included. Not original studies, case reports, simulation studies, systematic reviews, or studies that included patients who underwent TKA or unicompartmental arthroplasty (UKA) of the medial or lateral compartment of the knee, were excluded. Additionally, only articles that assessed functional and/or clinical outcomes, patient-reported outcomes (PROMs), radiographic progression of OA, complication rates, implant survival rates, pain, as well as conversion to TKA rates in patients treated with PFA, using inlay or onlay trochlea designs, were included. For quality assessment, the Methodological Index for Non-Randomized Studies (MINORS) for non-comparative and comparative clinical intervention studies was used. Results The literature search identified 404 articles. 29 of them met all the inclusion criteria following the selection process. Median MINORS for non-comparative studies value was 12.5 (range 11–14), and for comparative studies 20.1 (range 17–24). In terms of clinical and functional outcomes, no difference between onlay and inlay PFA has been described. Both designs yielded satisfactory results at short, medium and long-term follow-ups. Both designs improved pain postoperatively and no difference between them in terms of postoperative VAS has been noted, although the onlay groups presented a higher preoperative VAS. When comparing the inlay to onlay trochlea designs, the inlay group displayed a lower progression of OA rate. Conclusion There is no difference in functional or clinical outcomes after PFA between the new inlay and the onlay designs, with both presenting an improvement in most of the scores that were used. A higher rate of OA progression was observed in the onlay design group. Level of evidence III.

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