Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 10, pp 2047–2053 | Cite as

Revision following patello-femoral arthoplasty

  • Paul N. Baker
  • Ramsay Refaie
  • Paul Gregg
  • David Deehan
Knee

Abstract

Purpose

To describe the population of patients undergoing patello-femoral arthroplasty (PFA) revision and the reasons for which these implants are being revised. To compare this information with the observed failure patterns described in other national registries and with those seen for total knee replacement (TKR).

Methods

Using data accessed from the National Joint Registry for England and Wales, we identified 4634 primary PFA implanted between 1 April 2003 and 30 June 2010. As of 1 July 2010, 195 PFAs had been revised. The epidemiology of PFA revision is described with specific emphasis upon the reasons for revision.

Results

The median age at revision was 61 years (145 F:50 M). Revision occurred at a median of 2.0 years following primary surgery. Sixty of the 98 centres (61%) performing PFA revisions undertook only one such procedure. The 195 revisions were undertaken by 140 different consultants. Unexplained pain was the reason for revision in 46% of cases where a reason was stated. Progression of tibio-femoral arthritis was seen in only 14% of cases. Undiagnosed pain remained the most common reason for revision irrespective of patient age and time to revision, and was twice as common for PFA revision when compared to a matched group of failed TKR (43% vs. 19%, P < 0.001).

Conclusions

Unexplained pain is the principal indication for early revision of the failing PFA. The high proportion of revisions performed for unexplained pain raises questions about the adequacy of surgical selection for patients undergoing PFA.

Level of evidence

Retrospective comparative study, Level III.

Keywords

Patello-femoral Revision Failure Arthroplasty Registry 

Notes

Acknowledgments

We thank the patients and staff of all the hospitals in England and Wales who have contributed data to the National Joint Registry. We are grateful to the Healthcare Quality Improvement Partnership (HQIP), the NJR Steering committee and the staff at the NJR centre for facilitating this work. This work was funded by a fellowship from the National Joint Registry. The authors have conformed to the NJR’s standard protocol for data access and publication. The views expressed represent those of the authors and do not necessarily reflect those of the National Joint Register Steering committee or the Health Quality Improvement Partnership (HQIP) who do not vouch for how the information is presented.

Supplementary material

167_2011_1842_MOESM1_ESM.pdf (131 kb)
Supplementary material 1 (PDF 130 kb)

References

  1. 1.
    Ackroyd CE, Chir B (2005) Development and early results of a new patellofemoral arthroplasty. Clin Orthop Relat Res 436:7–13PubMedCrossRefGoogle Scholar
  2. 2.
    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(3):310–315CrossRefGoogle Scholar
  3. 3.
    Argenson JN, Flecher X, Parratte S, Aubaniac JM (2005) Patellofemoral arthroplasty: an update. Clin Orthop Relat Res 440:50–53PubMedCrossRefGoogle Scholar
  4. 4.
    Argenson JN, Guillaume JM, Aubaniac JM (1995) Is there a place for patellofemoral arthroplasty? Clin Orthop Relat Res 321:162–167PubMedGoogle Scholar
  5. 5.
    Cartier P, Sanouiller JL, Khefacha A (2005) Long-term results with the first patellofemoral prosthesis. Clin Orthop Relat Res 436:47–54PubMedCrossRefGoogle Scholar
  6. 6.
    Davies AP, Vince AS, Shepstone L, Donell ST, Glasgow MM (2002) The radiologic prevalence of patellofemoral osteoarthritis. Clin Orthop Relat Res 402:206–212PubMedCrossRefGoogle Scholar
  7. 7.
    Graves SE (2010) The value of arthroplasty registry data. Acta Orthop 81(1):8–9PubMedCrossRefGoogle Scholar
  8. 8.
    Leadbetter WB, Kolisek FR, Levitt RL, Brooker AF, Zietz P, Marker DR, Bonutti PM, Mont MA (2009) Patellofemoral arthroplasty: a multi-centre study with minimum 2-year follow-up. Int Orthop 33(6):1597–1601PubMedCrossRefGoogle Scholar
  9. 9.
    Leadbetter WB, Ragland PS, Mont MA (2005) The appropriate use of patellofemoral arthroplasty: an analysis of reported indications, contraindications, and failures. Clin Orthop Relat Res 436:91–99PubMedCrossRefGoogle Scholar
  10. 10.
    Lonner JH, Jasko JG, Booth RE Jr (2006) Revision of a failed patellofemoral arthroplasty to a total knee arthroplasty. J Bone Joint Surg (Am) 88(11):2337–2342CrossRefGoogle Scholar
  11. 11.
    Marsh JL, Hartz A (2003) Methodologic issues in observational studies. Clin Orthop Relat Res 413:33–42PubMedCrossRefGoogle Scholar
  12. 12.
    McKeever DC (1955) Patellar prosthesis. Clin Orthop Relat Res 404:3–6CrossRefGoogle Scholar
  13. 13.
    Mohammed R, Jimulia T, Durve K, Bansal M, Green M, Learmonth D (2008) Medium-term results of patellofemoral joint arthroplasty. Acta Orthop Belg 74(4):472–477PubMedGoogle Scholar
  14. 14.
    Mulford JS, Eldridge JDJ, Porteous AJ, Ackroyd CE, Newman JH (2009) Revision of isolated patellofemoral arthroplasty to total knee replacement. Curr Orthop Prac 20(4):437–441CrossRefGoogle Scholar
  15. 15.
    Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH (2006) Arthritis progression after patellofemoral joint replacement. Knee 13(4):290–295PubMedCrossRefGoogle Scholar
  16. 16.
    Odumenya M, Costa ML, Parsons N, Achten J, Dhillon M, Krikler SJ (2010) The Avon patellofemoral joint replacement: five-year results from an independent centre. J Bone Joint Surg (Br) 92(1):56–60CrossRefGoogle Scholar
  17. 17.
    Pearse AJ, Hooper GJ, Rothwell A, Frampton C (2010) Survival and functional outcome after revision of a unicompartmental to a total knee replacement: the New Zealand National Joint Registry. J Bone Joint Surg (Br) 92-B(4):508–512CrossRefGoogle Scholar
  18. 18.
    Tauro B, Ackroyd CE, Newman JH, Shah NA (2001) The Lubinus patellofemoral arthroplasty. A five- to ten-year prospective study. J Bone Joint Surg (Br) 83(5):696–701CrossRefGoogle Scholar
  19. 19.
    The Australian National Joint Replacement Registry: annual report 2010. http://www.dmac.adelaide.edu.au/aoanjrr/documents/aoanjrrreport_2010.pdf
  20. 20.
    The Danish Knee Arthroplasty Register: Annual report 2010. http://www.knee.dk/groups/dkr/pdf/DKRreportEnglish2010.pdf
  21. 21.
    The National Joint Registry for England and Wales: 7th annual report. http://www.njrcentre.org.uk/NjrCentre/LinkClick.aspx?fileticket=QkPI7kk6B2E%3D&tabid=86&mid=523
  22. 22.
  23. 23.
    The New Zealand National Joint Registry. Ten year report. http://www.cdhb.govt.nz/NJR/reports/A2D65CA3.pdf
  24. 24.
    The Norwegian Arthroplasty Register: annual report 2009. http://nrlweb.ihelse.net/eng/Annual_Report_2009.pdf
  25. 25.
    The Swedish Knee Arthoplasty Register: annual report 2009. http://www.knee.nko.se/english/online/uploadedFiles/113_SVK2009ENGL1.0.pdf

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Paul N. Baker
    • 1
    • 4
  • Ramsay Refaie
    • 2
  • Paul Gregg
    • 1
  • David Deehan
    • 2
    • 3
  1. 1.James Cook University HospitalMiddlesbroughUK
  2. 2.Royal Victoria InfirmaryNewcastle upon TyneUK
  3. 3.Freeman Road HospitalNewcastle upon TyneUK
  4. 4.Institute of Cellular Medicine, Medical SchoolUniversity of Newcastle upon TyneNewcastle upon TyneUK

Personalised recommendations