International Orthopaedics

, Volume 43, Issue 7, pp 1611–1620 | Cite as

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

  • Colin Y. L. Woon
  • Alexander B. Christ
  • Rie Goto
  • Kate Shanaghan
  • Beth E. Shubin Stein
  • Alejandro Gonzalez Della ValleEmail author
Review Article



Patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA) are accepted treatments for end-stage isolated patellofemoral osteoarthritis (PFOA). However, complications and re-operations have historically differed between the two procedures. We performed a systematic review to report on the re-operation rates between TKA and modern PFA for isolated PFOA.


Systematically identified publications reporting on patients that underwent either TKA or modern PFA for isolated PFOA were reviewed. Meta-analysis software was used to screen potential articles with at least one year follow-up that detailed reasons for re-operation. Data was extracted and analyzed for all re-operations. Survival of the implant was used as the primary outcome; return to the operating room (OR) for any reason was used as a secondary outcome.


The weighted rate of either conversion or revision arthroplasty in the PFA group and the TKA group was 6.34 and 0.11, respectively. The weighted rate of return to the OR for bony and soft tissue procedures was 1.06 and 0.79, respectively. The weighted rate of manipulation under anaesthesia (MUA) was 0.32 and 1.23, respectively.


Patients who undergo PFA may be more likely to return to the operating room for conversion to TKA and/or revision surgery than those who undergo TKA.


Isolated patellofemoral arthritis Isolated patellofemoral replacement Total knee replacment 



We are grateful to Kara Fields for her assistance in the statistical analysis.

Funding information

This study was partially funded by the generous donation of Mr. Glenn Bergenfield, the Sidney Milton and Leoma Simon Foundation, and by Ms. Elizabeth Kim.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  • Colin Y. L. Woon
    • 1
  • Alexander B. Christ
    • 1
  • Rie Goto
    • 2
  • Kate Shanaghan
    • 1
  • Beth E. Shubin Stein
    • 3
  • Alejandro Gonzalez Della Valle
    • 1
    Email author
  1. 1.Adult Reconstruction and Joint Replacement ServiceHospital for Special SurgeryNew YorkUSA
  2. 2.Kim Barrett Memorial LibraryHospital for Special SurgeryNew YorkUSA
  3. 3.Sports Medicine ServiceHospital for Special SurgeryNew YorkUSA

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