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Treating Patellofemoral Arthritis with Patellofemoral Arthroplasty

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Unicompartmental Knee Arthroplasty

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Abstract

Isolated patellofemoral osteoarthritis (PF OA) is a relatively uncommon disorder that may lead to significant pain and disability in affected patients. Patellofemoral arthroplasty (PFA) is effective for the treatment of patellofemoral OA. Historically, high failure rates were associated with PFA related to component malpositioning, soft-tissue imbalance, and poor trochlear implant designs. As a result, PFA had been underutilized in the treatment of isolated patellofemoral OA. The evolution of surgical indications, technique, and the development of onlay-style trochlear components have improved patellar tracking, functional outcomes, and longevity of modern PFA. In fact, studies have demonstrated improved function and survivorship, as well as a lower incidence of patellar maltracking, when utilizing modern onlay-style trochlear implants. The presence of Grade III or IV tibiofemoral chondromalacia or OA remains a contraindication to the performance of PFA in isolation; however, in select patients, combining PFA with UKA (the so-called modular bicompartmental knee arthroplasty [BiKA]) or condylar cartilage grafting may provide good outcomes and expand the role of partial knee arthroplasty, as an alternative to total knee arthroplasty (TKA). Ultimately, as with any limited arthroplasty procedure, careful attention to patient selection, surgical technique, and implant selection are critical to achieving success in PFA.

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References

  1. Davies AP, Vince AS, Shepstone L, Donell ST, Glasgow MM. The radiologic prevalence of patellofemoral osteoarthritis. Clin Orthop Relat Res. 2002;402:206–12.

    Article  Google Scholar 

  2. McAlindon TE, Snow S, Cooper C, Dieppe PA. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992;51(7):844–9.

    Article  CAS  Google Scholar 

  3. Kobayashi S, Pappas E, Fransen M, Refshauge K, Simic M. The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil. 2016;24(10):1697–707.

    Article  CAS  Google Scholar 

  4. Collins NJ, Oei EHG, de Kanter JL, Vicenzino B, Crossley KM. Prevalence of Radiographic and Magnetic Resonance Imaging Features of Patellofemoral Osteoarthritis in Young and Middle-Aged Adults With Persistent Patellofemoral Pain. Arthritis Care Res (Hoboken). 2019;71(8):1068–1073.

    Google Scholar 

  5. Pisanu G, et al. Patellofemoral arthroplasty: current concepts and review of the literature. Joints. 2017;5(4):237–45.

    Article  Google Scholar 

  6. Duncan R, Peat G, Thomas E, Wood L, Hay E, Croft P. Does isolated patellofemoral osteoarthritis matter? Osteoarthr Cartil. 2009;17(9):1151–5.

    Article  CAS  Google Scholar 

  7. Lonner JH, Bloomfield MR. The clinical outcome of patellofemoral arthroplasty. Orthop Clin North Am. 2013;44(3):271–80.

    Article  Google Scholar 

  8. Lonner JH. Patellofemoral arthroplasty. J Am Acad Orthop Surg. 2007;15(8):495–506.

    Article  Google Scholar 

  9. Walker T, Perkinson B, Mihalko W. Instructional course lectures patellofemoral arthroplasty: the other. JBJS Am. 2012;94(2013):1713–20.

    Google Scholar 

  10. Liow MHL, Goh GSH, Tay DKJ, Chia SL, Lo NN, Yeo SJ. Obesity and the absence of trochlear dysplasia increase the risk of revision in patellofemoral arthroplasty. Knee. 2016;23(2):331–7.

    Article  Google Scholar 

  11. van Jonbergen HPW, Werkman DM, Barnaart LF, van Kampen A. Long-term outcomes of patellofemoral arthroplasty. J Arthroplast. 2010;25(7):1066–71.

    Article  Google Scholar 

  12. Wagner ER, Kamath AF, Fruth K, Harmsen WS, Berry DJ. Effect of body mass index on reoperation and complications after total knee arthroplasty. J Bone Joint Surg Am. 2016;98(24):2052–60.

    Article  Google Scholar 

  13. Leadbetter WB. Patellofemoral arthroplasty in the treatment of patellofemoral arthritis: rationale and outcomes in younger patients. Orthop Clin North Am. 2008;39(3):363–80,. , vii.

    Article  Google Scholar 

  14. Delanois RE, et al. Results of total knee replacement for isolated patellofemoral arthritis: when not to perform a patellofemoral arthroplasty. Orthop Clin North Am. 2008;39(3):381–8.

    Article  Google Scholar 

  15. Kazarian GS, Tarity TD, Hansen EN, Cai J, Lonner JH. Significant functional improvement at 2 years after isolated patellofemoral arthroplasty with an onlay trochlear implant, but low mental health scores predispose to dissatisfaction. J Arthroplast. 2016;31(2):389–94.

    Article  Google Scholar 

  16. Levitt RL. A long-term evaluation of patellar prostheses. Clin Orthop Relat Res. 1973;97:153–7.

    Article  Google Scholar 

  17. Vermeulen H, De Doncker E, Watillon M. The Mac Keever patellar prosthesis in femoro-patellar arthrosis. Acta Orthop Belg. 1973;39(1):79–90.

    CAS  PubMed  Google Scholar 

  18. Lonner JH. Patellofemoral arthroplasty: the impact of design on outcomes. Orthop Clin North Am. 2008;39(3):347–54,. , vi.

    Article  Google Scholar 

  19. Kamath AF, Slattery TR, Levack AE, Wu CH, Kneeland JB, Lonner JH. Trochlear inclination angles in normal and dysplastic knees. J Arthroplast. 2013;28(2):214–9.

    Article  Google Scholar 

  20. Blazina ME, Fox JM, Del Pizzo W, Broukhim B, Ivey FM. Patellofemoral replacement. Clin Orthop Relat Res. 1979;436:3–6, Jul. 2005.

    Google Scholar 

  21. Krajca-Radcliffe JB, Coker TP. Patellofemoral arthroplasty. A 2- to 18-year followup study. Clin Orthop Relat Res. 1996;330:143–51.

    Article  Google Scholar 

  22. Arciero RA, Toomey HE. Patellofemoral arthroplasty. A three- to nine-year follow-up study. Clin Orthop Relat Res. 1988;236:60–71.

    Google Scholar 

  23. de Winter WE, Feith R, van Loon CJ. The Richards type II patellofemoral arthroplasty: 26 cases followed for 1-20 years. Acta Orthop Scand. 2001;72(5):487–90.

    Article  Google Scholar 

  24. Kooijman HJ, Driessen APPM, van Horn JR. Long-term results of patellofemoral arthroplasty. A report of 56 arthroplasties with 17 years of follow-up. J Bone Joint Surg (Br). 2003;85(6):836–40.

    Article  CAS  Google Scholar 

  25. Tauro B, Ackroyd CE, Newman JH, Shah NA. The Lubinus patellofemoral arthroplasty. A five- to ten-year prospective study. J Bone Joint Surg (Br). 2001;83(5):696–701.

    Article  CAS  Google Scholar 

  26. Lonner JH. Patellofemoral arthroplasty. Clin Orthop Relat Res. 2004;428(8):158–65.

    Article  Google Scholar 

  27. Board TN, Mahmood A, Ryan WG, Banks AJ. The Lubinus patellofemoral arthroplasty: a series of 17 cases. Arch Orthop Trauma Surg. 2004;124(5):285–7.

    Article  CAS  Google Scholar 

  28. Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH. Arthritis progression after patellofemoral joint replacement. Knee. 2006;13:290–5.

    Article  Google Scholar 

  29. Mont MA, Johnson AJ, Naziri Q, Kolisek FR, Leadbetter WB. Patellofemoral arthroplasty. 7-year mean follow-up. J Arthroplast. 2012;27(3):358–61.

    Article  Google Scholar 

  30. Lonner JH, Mehta S, Booth RE. Ipsilateral patellofemoral arthroplasty and autogenous osteochondral femoral condylar transplantation. J Arthroplast. 2007;22(8):1130–6.

    Article  Google Scholar 

  31. Metcalfe AJ, et al. The Avon patellofemoral joint arthroplasty. Bone Joint J. 2018;100–B(9):1162–7.

    Article  Google Scholar 

  32. Han M, et al. The knee obesity and the absence of trochlear dysplasia increase the risk of revision in patellofemoral arthroplasty. Knee. 2016;23(2):331–7.

    Article  Google Scholar 

  33. Dahm DL, Kalisvaart MM, Stuart MJ, Slettedahl SW. Patellofemoral arthroplasty: outcomes and factors associated with early progression of tibiofemoral arthritis. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2554–9.

    Article  Google Scholar 

  34. Hendrix MRG, Ackroyd CE, Lonner JH. Revision patellofemoral arthroplasty. Three- to seven-year follow-up. J Arthroplast. 2008;23(7):977–83.

    Article  Google Scholar 

  35. Odgaard A, Madsen F, Kristensen PW, Kappel A, Fabrin J. The Mark Coventry award. Clin Orthop Relat Res. 2018;476(1):87–100.

    Article  Google Scholar 

  36. “Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR): 2018 Annual Report,” 2018.

    Google Scholar 

  37. Lonner JH. Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res. 2004;428:158–65.

    Article  Google Scholar 

  38. Dahm DL, Al-Rayashi W, Dajani K, Shah JP, Levy BA, Stuart MJ. Patellofemoral arthroplasty versus total knee arthroplasty in patients with isolated patellofemoral osteoarthritis. Am J Orthop (Belle Mead NJ). 2010;39(10):487–91.

    Google Scholar 

  39. Dy CJ, Franco N, Mazumdar M, Mccarthy MM, Della Valle AG. Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2012;20(11):2174–90.

    Article  CAS  Google Scholar 

  40. Argenson J-NA, Flecher X, Parratte S, Aubaniac J-M. Patellofemoral arthroplasty: an update. Clin Orthop Relat Res. 2005;440:50–3.

    Article  Google Scholar 

  41. Ackroyd CE, Newman JH, Evans R, Eldridge JDJ, Joslin CC. The Avon patellofemoral arthroplasty: five-year survivorship and functional results. J Bone Joint Surg Br. 2007;89(3):310–315.

    Google Scholar 

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Authors and Affiliations

  1. Rothman Orthopaedic Institute, Department of Orthopaedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

    Kevin J. Choo & Jess H. Lonner

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  1. Kevin J. Choo
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  2. Jess H. Lonner
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Correspondence to Jess H. Lonner .

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Editors and Affiliations

  1. Adult Reconstruction Division, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Tad L. Gerlinger

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Choo, K.J., Lonner, J.H. (2020). Treating Patellofemoral Arthritis with Patellofemoral Arthroplasty. In: Gerlinger, T. (eds) Unicompartmental Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-27411-5_10

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  • DOI: https://doi.org/10.1007/978-3-030-27411-5_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27410-8

  • Online ISBN: 978-3-030-27411-5

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