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No bias for developer publications and no difference between first-generation trochlear-resurfacing versus trochlear-cutting implants in 15,306 cases of patellofemoral joint arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose and hypothesis

The study aim was to assess the outcome of patellofemoral arthroplasty (PFA), paying particular interest to ‘revisions for any reason’. The hypothesis was that there is a superior outcome of PFA reported in dependent clinical studies in contrast to independent clinical literature and that there is a superior outcome of ‘trochlear-cutting’ PFA in comparison with ‘first-generation trochlear-resurfacing’ implants.

Methods

Studies on PFA from its market introduction in 1955 onwards were systematically reviewed. The revision rate, which was calculated as ‘revisions per 100 component years (CY)’, was evaluated in 45 studies published in indexed, peer-reviewed international scientific journals. In addition, ‘first-generation trochlear-resurfacing’ and ‘trochlear-cutting’ implants as well as dependent and independent clinical literature were analysed. Furthermore, the data of three arthroplasty registers were analysed.

Results

A total of 15,306 PFA were included consisting of 2266 cases in worldwide literature data and of 13,040 cases in register data. 2.22 revisions per 100 CY were observed in worldwide literature data, which corresponds to a revision rate of 22.2% after 10 years. Revision rates between 18.9 and 27% after 10 years were shown by the included three national joint registers. In the group analyses no significant differences were detected.

Conclusions

This meta-analysis did not reveal significant differences in the comparison between developer over independent publications and between ‘first-generation-resurfacing’ over ‘trochlear-cutting’ implants. In conclusion the data of developer publications do not seem to be biased. ‘Trochlear-cutting’ devices of PFA had slightly superior outcomes, but that benefit was not statistically significant. Nevertheless, we would recommend ‘trochlear-cutting’ devices for further use in PFA.

Level of evidence

Meta-analysis of Level IV case series.

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Acknowledgements

Editing for language use by Veronika Doblhoff-Löffler is gratefully acknowledged. No funding was obtained for this work.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria

    Birgit Reihs, Florian Reihs, Andreas Leithner & Patrick Sadoghi

  2. Medical University of Innsbruck, Innsbruck, Austria

    Gerold Labek

  3. Department of Orthopaedic Surgery, Landeskrankenhaus Stolzalpe, Murau, Austria

    Markus Hochegger

  4. Department of Orthopaedic Surgery, AKH Linz, Linz, Austria

    Nikolaus Böhler

Authors
  1. Birgit Reihs
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  2. Florian Reihs
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  3. Gerold Labek
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  4. Markus Hochegger
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  5. Andreas Leithner
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  6. Nikolaus Böhler
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  7. Patrick Sadoghi
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Corresponding author

Correspondence to Patrick Sadoghi.

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Conflict of interest

No benefits in any form have been received or will be received from a commercial party directly or indirectly to the subject of this article.

Funding

No fundings were received for this study.

Ethical approval

No ethical approval was necessary as requested by the regional IRB due to the nature of the study design.

Appendix: search terms via Ovid

Appendix: search terms via Ovid

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Medline

((exp knee joint/or exp patellofemoral joint/or Osteoarthritis, Knee/di, su, th or Patella/ab, su or Femur/su) and (Arthroplasty, Replacement, Knee/or prosthesis failure/or prosthesis-related infections/) and (patellofemoral or femoropatellar).mp.) not (“tka” or “total knee” or “unicondylar”)

Embase

((exp knee joint/or exp patellofemoral joint/or Osteoarthritis, Knee/di, su, th or Patella/ab, su or Femur/su) and (Arthroplasty, Replacement, Knee/or prosthesis failure/or prosthesis-related infections/) and (patellofemoral or femoropatellar).mp.) not (“tka” or “unicondylar” or “total knee”).ti.

Central

(exp Patellofemoral Joint/su or Knee Joint/su or Patella/or Femur/su or Osteoarthritis, Knee/) and (patellofemoral or femoropatellar).mp. and (arthroplasty, replacement, knee/or arthroplasty.mp. or replacement.mp. or prosthesis.mp.)

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Reihs, B., Reihs, F., Labek, G. et al. No bias for developer publications and no difference between first-generation trochlear-resurfacing versus trochlear-cutting implants in 15,306 cases of patellofemoral joint arthroplasty. Knee Surg Sports Traumatol Arthrosc 26, 2809–2816 (2018). https://doi.org/10.1007/s00167-017-4692-6

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  • DOI: https://doi.org/10.1007/s00167-017-4692-6

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