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Are results of total knee arthroplasty for isolated patellofemoral OA as good as for medial compartment OA? A medium-term retrospective comparative study

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Abstract

Purpose

The aim of this study was to compare the results of isolated patellofemoral arthritis (IPFA) treated using a total knee arthroplasty (TKA) compared to the results of medial tibiofemoral arthritis treated with a TKA. We hypothesised that there would be no difference between functional outcomes for the two groups.

Methods

Between 2003 and 2009, 32 TKAs were performed for IPFA (group I). Over this time period, a total of 813 primary TKAs were performed from which we identified a second group of patients who had undergone TKA for isolated medial tibiofemoral arthritis (group II: n = 32). These patients were matched based on age, sex, body mass index and average follow-up. The average age of patients in group I was 72.81 ± 6.6 years (59–83) and 71.97 ± 6.8 years in group II. The global International Knee Society (IKS) score was statistically significantly better in group I (114.72 ± 22 points) than in group II (84.9 ± 23.8). This difference was accounted for by better passive flexion, better walking distance and the absence of any coronal plane deformity.

Results

A total of 29 patients from group I were reviewed at an average follow-up of 64.58 ± 23.4 months, and 30 patients in group II were reviewed at an average follow-up of 66.13 ± 23.9 months (three were lost to follow-up in group I and two in group II). At final follow-up, there was statistically no difference between the two groups IKS score (175.34 ± 19.26 in group I vs. 170.13 ± 24.14 for group II) or Hospital for Special Surgery patella score (89.31 ± 9.98 points for group I vs. 89.16 ± 11.45 points for group II). We found no significant radiological difference between the two groups including patella height and orientation on axial views.

Conclusions

The results of TKA for IPFA are as good as the results of TKA for isolated medial tibiofemoral arthritis with well-functioning prosthetic patellofemoral articulations. These results support our institutional preference for using TKA as treatment for IPFA in patients over 65–70 years old.

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References

  1. Kelly MA, Clarke HD (2002) Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res 404:51–57

    Article  PubMed  Google Scholar 

  2. Ritter MA (2009) The Anatomical Graduated Component total knee replacement: a long-term evaluation with 20-year survival analysis. J Bone Joint Surg Br 91:745–749

    Article  CAS  PubMed  Google Scholar 

  3. Pavone V, Boettner F, Fickert S, Sculco TP (2001) Total condylar knee arthroplasty: a long-term follow-up. Clin Orthop Relat Res 388:18–25

    Article  PubMed  Google Scholar 

  4. Argenson JN, Parratte S, Ashour A, Saintmard B, Aubaniac JM (2012) The outcome of rotating—platform total knee arthroplasty with cement at a minimum of ten years of follow-up. J Bone Joint Surg Am 94:638–644

    Article  PubMed  Google Scholar 

  5. Lonner JH (2004) Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res 428:158–165

    Article  PubMed  Google Scholar 

  6. Sisto DJ, Sarin VK (2006) Custom patellofemoral arthroplasty of the knee. J Bone Joint Surg Am 88:1475–1480

    Article  PubMed  Google Scholar 

  7. Grelsamer RP, Stein DA (2006) Current concepts review: patellofemoral arthritis. J Bone Joint Surg Am 88:1849–1860

    Article  PubMed  Google Scholar 

  8. Blazina ME, Fox JM, Del Pizzo W, Roukhim B, Ivey FM (1979) Patellofemoral replacement. Clin Orthop Relat Res 144:98–102

    PubMed  Google Scholar 

  9. de Winter WE, Feith R, van Loon CJ (2001) The Richards Type II patellofemoral arthroplasty: 26 cases followed for 1–20 years. Acta Orthop Scand 72:487–490

    Article  PubMed  Google Scholar 

  10. Smith AM, Peckett WR, Butler-Manuel PA, Venu KM, d’Arcy JC (2002) Treatment of patello-femoral arthritis using the Lubinus patello-femoral arthroplasty: a retrospective review. Knee 9:27–30

    Article  CAS  PubMed  Google Scholar 

  11. Kooijman HJ, Driessen AP, van Horn JR (2003) Long-term results of patellofemoral arthroplasty: a report of 56 arthroplasties with 17 years of follow-up. J Bone Joint Surg Br 85:836–840

    CAS  PubMed  Google Scholar 

  12. Merchant AC (2004) Early results with a total patellofemoral joint replacement arthroplasty prosthesis. J Arthroplasty 19:829–836

    Article  PubMed  Google Scholar 

  13. Merchant AC (2005) A modular prosthesis for patellofemoral arthroplasty: design and initial results. Clin Orthop Relat Res 436:40–46

    Article  PubMed  Google Scholar 

  14. Ackroyd CE, Chir B (2005) Development and early results of a new patellofemoral arthroplasty. Clin Orthop Relat Res 436:7–13

    Article  PubMed  Google Scholar 

  15. Cossey AJ, Spriggins AJ (2006) Computer-assisted patellofemoral arthroplasty: a mechanism for optimizing rotation. J Arthroplasty 21:420–427

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  17. Dy CJ, Franco N, Ma Y, Mazumdar M, McCarthy MM, Gonzalez Della Valle A (2012) Complications after patello-femoral versus total knee replacement in the treatment of isolated patello-femoral osteoarthritis. A meta-analysis. Knee Surg Sports Traumatol Arthrosc 20:2174–2190

    Article  CAS  PubMed  Google Scholar 

  18. Iwano T, Kurosawa H, Tokuyama H, Hoshikawa Y (1990) Roentgenographic and clinical findings of patellofemoral osteoarthrosis. Clin Orthop Relat Res 253:190–197

    Google Scholar 

  19. Saragaglia D, Roberts J (2005) Navigated osteotomies around the knee in 170 patients with osteoarthritis secondary to genu varum. Orthopaedics 28(Suppl. no 10):S1269–S1274

    Google Scholar 

  20. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  21. Tavernier T, Dejour D (2001) Knee imaging: what is the best modality. J Radiol 82(3 Pt 2):387–405; 407–408

  22. Wiberg G (1941) Roentgenographic and anatomic studies on the femoropatellar joint. Acta Orthop Scand 12:319–410

    Article  Google Scholar 

  23. Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  24. Cartier P, Sanouiller JL, Khefacha A (2005) Long-term results with the first patellofemoral prosthesis. Clin Orthop Relat Res 436:47–54

    Article  PubMed  Google Scholar 

  25. Dahm DL, Al-Rayashi W, Dajani K, Shah JP, Levy BA, Stuart MJ (2010) Patellofemoral arthroplasty versus total knee arthroplasty in patients with isolated patellofemoral osteoarthritis. Am J Orthop 39:487–491

    PubMed  Google Scholar 

  26. Parvizi J, Stuart MJ, Pagnano MW, Hanssen AD (2001) Total knee arthroplasty in patients with isolated patellofemoral arthritis. Clin Orthop Relat Res 392:147–152

    Article  PubMed  Google Scholar 

  27. Dalury DF (2005) Total knee replacement for patellofemoral disease. Knee 18:274–277

    Google Scholar 

  28. Mont MA, Haas S, Mullick T, Hungerford DS (2002) Total knee arthroplasty for patellofemoral arthritis. J Bone Joint Surg Am 84:1977–1981

    PubMed  Google Scholar 

  29. Thompson NW, Ruiz AL, Breslin E, Beverland DE (2001) Total knee arthroplasty without patellar resurfacing in isolated patellofemoral osteoarthritis. J Arthroplasty 16:607–612

    Article  CAS  PubMed  Google Scholar 

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The authors declare no conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, Avenue de Kimberley, BP 338, 38434, Échirolles, France

    D. Saragaglia & R. Mader

  2. Department of Trauma and Orthopaedics, Wansbeck Hospital, Northumberland, UK

    R. Refaie

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  1. D. Saragaglia
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  2. R. Mader
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  3. R. Refaie
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Correspondence to D. Saragaglia.

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Saragaglia, D., Mader, R. & Refaie, R. Are results of total knee arthroplasty for isolated patellofemoral OA as good as for medial compartment OA? A medium-term retrospective comparative study. Eur J Orthop Surg Traumatol 25, 381–386 (2015). https://doi.org/10.1007/s00590-014-1516-y

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  • DOI: https://doi.org/10.1007/s00590-014-1516-y

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