Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 7, pp 1216–1226 | Cite as

Patellofemoral arthroplasty, where are we today?

  • Sébastien Lustig
  • Robert A. Magnussen
  • Diane L. Dahm
  • David Parker
Knee

Abstract

Purpose

Patellofemoral arthroplasty remains controversial, primarily due to the high failure rates reported with early implants. Numerous case series have been published over the years detailing results of various first- and second-generation implants. The purpose of this work is to summarize results published to date and identify common themes regarding implants, surgical techniques, and indications in order to maximize results of future procedures.

Methods

A comprehensive review of the MEDLINE database was carried out to identify all clinical studies related to patellofemoral arthroplasty.

Results

First-generation resurfacing implants were associated with relatively high failure rates in the medium term. Second-generation implants, with femoral cuts based on TKA designs have yielded more promising medium-term results. Surgical indications are specific and must be carefully followed to minimize poor results. Short-term complications are generally related to patellar maltracking, while long-term complications are generally related to progression of osteoarthritis in the tibiofemoral joint. Implant loosening and polyethylene wear are rarely reported. Short-term results are favourable for new technology including custom implants and computer navigated surgery.

Conclusions

Overall, recent improvements in implant design and surgical techniques have resulted in improvements in short- and medium-term results. More work is required to assess the long-term outcomes of modern implant designs.

Level of evidence

IV.

Keywords

Knee Patellofemoral joint Arthroplasty Results 

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 (2003) The Avon patellofemoral arthroplasty: two to five year results. J Bone Joint Surg Br 85:162–163CrossRefGoogle Scholar
  3. 3.
    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 89:310–315PubMedGoogle Scholar
  4. 4.
    Amis AA, Senavongse W, Darcy P (2005) Biomechanics of patellofemoral joint prostheses. Clin Orthop Relat Res 436:20–29PubMedCrossRefGoogle Scholar
  5. 5.
    Arciero RA, Toomey HE (1988) Patellofemoral arthroplasty. A three- to nine-year follow-up study. Clin Orthop Relat Res 236:60–71PubMedGoogle Scholar
  6. 6.
    Argenson JN, Flecher X, Parratte S, Aubaniac JM (2005) Patellofemoral arthroplasty: an update. Clin Orthop Relat Res 440:50–53PubMedCrossRefGoogle Scholar
  7. 7.
    Argenson JN, Guillaume JM, Aubaniac JM (1995) Is there a place for patellofemoral arthroplasty? Clin Orthop Relat Res 321:162–167PubMedGoogle Scholar
  8. 8.
    Arumilli BR, Ng AB, Ellis DJ, Hirst P (2010) Unusual mechanical complications of unicompartmental low contact stress mobile bearing patellofemoral arthroplasty: a cause for concern? Knee 17:362–364PubMedCrossRefGoogle Scholar
  9. 9.
    Becker R, Ropke M, Krull A, Musahl V, Nebelung W (2008) Surgical treatment of isolated patellofemoral osteoarthritis. Clin Orthop Relat Res 466:443–449PubMedCrossRefGoogle Scholar
  10. 10.
    Blazina ME, Fox JM, Del Pizzo W, Broukhim B, Ivey FM (1979) Patellofemoral replacement. Clin Orthop Relat Res 144:98–102PubMedGoogle Scholar
  11. 11.
    Board TN, Mahmood A, Ryan WG, Banks AJ (2004) The Lubinus patellofemoral arthroplasty: a series of 17 cases. Arch Orthop Trauma Surg 124:285–287PubMedCrossRefGoogle Scholar
  12. 12.
    Butler JE, Shannon R (2009) Patellofemoral arthroplasty with a custom-fit femoral prosthesis. Orthopedics 32:81PubMedGoogle Scholar
  13. 13.
    Cartier P, Sanouiller JL, Grelsamer R (1990) Patellofemoral arthroplasty. 2–12-year follow-up study. J Arthroplasty 5:49–55PubMedCrossRefGoogle Scholar
  14. 14.
    Cartier P, Sanouiller JL, Khefacha A (2005) Long-term results with the first patellofemoral prosthesis. Clin Orthop Relat Res 436:47–54PubMedCrossRefGoogle Scholar
  15. 15.
    Charalambous CP, Abiddin Z, Mills SP, Rogers S, Sutton P, Parkinson R (2011) The low contact stress patellofemoral replacement: high early failure rate. J Bone Joint Surg Br 93:484–489PubMedCrossRefGoogle Scholar
  16. 16.
    Cobb J, Henckel J, Gomes P, Harris S, Jakopec M, Rodriguez F, Barrett A, Davies B (2006) Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 88:188–197PubMedGoogle Scholar
  17. 17.
    Cossey AJ, Spriggins AJ (2006) Computer-assisted patellofemoral arthroplasty: a mechanism for optimizing rotation. J Arthroplasty 21:420–427PubMedCrossRefGoogle Scholar
  18. 18.
    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 (Belle Mead NJ) 39:487–491Google Scholar
  19. 19.
    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
  20. 20.
    Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69PubMedCrossRefGoogle Scholar
  21. 21.
    De Cloedt P, Legaye J, Lokietek W (1999) Femoro-patellar prosthesis. A retrospective study of 45 consecutive cases with a follow-up of 3–12 years. Acta Orthop Belg 65:170–175PubMedGoogle Scholar
  22. 22.
    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 72:487–490PubMedCrossRefGoogle Scholar
  23. 23.
    Farr J 2nd, Barrett D (2008) Optimizing patellofemoral arthroplasty. Knee 15:339–347PubMedCrossRefGoogle Scholar
  24. 24.
    Feller JA, Bartlett RJ, Lang DM (1996) Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br 78:226–228PubMedGoogle Scholar
  25. 25.
    Fulkerson JP, Shea KP (1990) Disorders of patellofemoral alignment. J Bone Joint Surg Am 72:1424–1429PubMedGoogle Scholar
  26. 26.
    Gadeyne S, Besse JL, Galand-Desme S, Lerat JL, Moyen B (2008) Results of self-centering patellofemoral prosthesis: a retrospective study of 57 implants. Rev Chir Orthop Reparatrice Appar Mot 94:228–240PubMedCrossRefGoogle Scholar
  27. 27.
    Hassaballa MA, Porteous AJ, Newman JH (2004) Observed kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty: perception versus reality. Knee Surg Sports Traumatol Arthrosc 12:136–139PubMedCrossRefGoogle Scholar
  28. 28.
    Hendrix MR, Ackroyd CE, Lonner JH (2008) Revision patellofemoral arthroplasty: three- to seven-year follow-up. J Arthroplasty 23:977–983PubMedCrossRefGoogle Scholar
  29. 29.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  30. 30.
    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 85:836–840PubMedGoogle Scholar
  31. 31.
    Krajca-Radcliffe JB, Coker TP (1996) Patellofemoral arthroplasty. A 2- to 18-year followup study. Clin Orthop Relat Res 330:143–151PubMedCrossRefGoogle Scholar
  32. 32.
    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 33:1597–1601PubMedCrossRefGoogle Scholar
  33. 33.
    Leadbetter WB, Mont MA (2009) Patellofemoral arthroplasty: a useful option for recalcitrant symptomatic patellofemoral arthritis. Semin Arthro 20:148–160CrossRefGoogle Scholar
  34. 34.
    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
  35. 35.
    Leadbetter WB, Seyler TM, Ragland PS, Mont MA (2006) Indications, contraindications, and pitfalls of patellofemoral arthroplasty. J Bone Joint Surg Am 88(Suppl 4):122–137PubMedCrossRefGoogle Scholar
  36. 36.
    Levitt RL (1973) A long-term evaluation of patellar prostheses. Clin Orthop Relat Res 97:153–157PubMedCrossRefGoogle Scholar
  37. 37.
    Lonner JH (2004) Patellofemoral arthroplasty: pros, cons, and design considerations. Clin Orthop Relat Res 428:158–165PubMedCrossRefGoogle Scholar
  38. 38.
    Lonner JH (2006) Patellofemoral arthroplasty. In: Scott N (ed) Insall and Scott surgery of the knee, 4th edn. Elsevier, Philadelphia, pp 1440–1454Google Scholar
  39. 39.
    Lonner JH (2007) Patellofemoral arthroplasty. J Am Acad Orthop Surg 15:495–506PubMedGoogle Scholar
  40. 40.
    Lonner JH (2009) Modular bicompartmental knee arthroplasty with robotic arm assistance. Am J Orthop (Belle Mead NJ) 38:28–31Google Scholar
  41. 41.
    Lonner JH (2010) Patellofemoral arthroplasty. Instr Course Lect 59:67–84PubMedGoogle Scholar
  42. 42.
    Lonner JH, Mehta S, Booth RE Jr (2007) Ipsilateral patellofemoral arthroplasty and autogenous osteochondral femoral condylar transplantation. J Arthroplasty 22:1130–1136PubMedCrossRefGoogle Scholar
  43. 43.
    Lubinus HH (1979) Patella glide-bearing total replacement. Orthopedics 2:119–127Google Scholar
  44. 44.
    Lustig S, Fleury C, Goy D, Neyret P, Donell ST (2011) The accuracy of acquisition of an imageless computer-assisted system and its implication for knee arthroplasty. Knee 18:15–20PubMedCrossRefGoogle Scholar
  45. 45.
    McKeever DC (1955) Patellar prosthesis. J Bone Joint Surg Am 37-A:1074–1084Google Scholar
  46. 46.
    Merchant AC (2005) A modular prosthesis for patellofemoral arthroplasty: design and initial results. Clin Orthop Relat Res 436:40–46PubMedCrossRefGoogle Scholar
  47. 47.
    Mertl P, Van FT, Bonhomme P, Vives P (1997) Femoropatellar osteoarthritis treated by prosthesis. Retrospective study of 50 implants. Rev Chir Orthop Reparatrice Appar Mot 83:712–718PubMedGoogle Scholar
  48. 48.
    Mofidi A, Bajada S, Holt MD, Davies AP (2011) Functional relevance of patellofemoral thickness before and after unicompartmental patellofemoral replacement. Knee PMID:21498901Google Scholar
  49. 49.
    Morra EA, Greenwald AS (2006) Patellofemoral replacement polymer stress during daily activities: a finite element study. J Bone Joint Surg Am 88(Suppl 4):213–216PubMedCrossRefGoogle Scholar
  50. 50.
    Newman JH (2007) Patellofemoral arthritis and its management with isolated patellofemoral replacement: a personal experience. Orthopedics 30:58–61PubMedGoogle Scholar
  51. 51.
    Nicol SG, Loveridge JM, Weale AE, Ackroyd CE, Newman JH (2006) Arthritis progression after patellofemoral joint replacement. Knee 13:290–295PubMedCrossRefGoogle Scholar
  52. 52.
    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 92:56–60PubMedCrossRefGoogle Scholar
  53. 53.
    Oni OOA (1996) The Leicester patello-femoral joint prosthesis. Knee 3:81–82CrossRefGoogle Scholar
  54. 54.
    Parratte S, Pauly V, Aubaniac JM, Argenson JN (2010) Survival of bicompartmental knee arthroplasty at 5 to 23 years. Clin Orthop Relat Res 468:64–72PubMedCrossRefGoogle Scholar
  55. 55.
    Parvizi J, Stuart MJ, Pagnano MW, Hanssen AD (2001) Total knee arthroplasty in patients with isolated patellofemoral arthritis. Clin Orthop Relat Res 392:147–152PubMedCrossRefGoogle Scholar
  56. 56.
    Paxton EW, Fithian DC (2005) Outcome instruments for patellofemoral arthroplasty. Clin Orthop Relat Res 436:66–70PubMedCrossRefGoogle Scholar
  57. 57.
    Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee injury and osteoarthritis outcome score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96PubMedGoogle Scholar
  58. 58.
    Sisto DJ, Sarin VK (2006) Custom patellofemoral arthroplasty of the knee. J Bone Joint Surg Am 88:1475–1480PubMedCrossRefGoogle Scholar
  59. 59.
    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 9:27–30PubMedCrossRefGoogle Scholar
  60. 60.
    Starks I, Roberts S, White SH (2009) The Avon patellofemoral joint replacement: independent assessment of early functional outcomes. J Bone Joint Surg Br 91:1579–1582PubMedCrossRefGoogle Scholar
  61. 61.
    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 83:696–701PubMedCrossRefGoogle Scholar
  62. 62.
    van Jonbergen HP, Werkman DM, Barnaart AF (2009) Dissociation of mobile-bearing patellar component in low contact stress patellofemoral arthroplasty, its mechanism and management: two case reports. Cases J 2:7502PubMedCrossRefGoogle Scholar
  63. 63.
    van Jonbergen HP, Werkman DM, Barnaart LF, van Kampen A (2010) Long-term outcomes of patellofemoral arthroplasty. J Arthroplasty 25:1066–1071PubMedCrossRefGoogle Scholar
  64. 64.
    van Jonbergen HP, Werkman DM, van Kampen A (2009) Conversion of patellofemoral arthroplasty to total knee arthroplasty: A matched case-control study of 13 patients. Acta Orthop 80:62–66PubMedCrossRefGoogle Scholar
  65. 65.
    van Wagenberg JM, Speigner B, Gosens T, de Waal Malefijt J (2009) Midterm clinical results of the Autocentric II patellofemoral prosthesis. Int Orthop 33:1603–1608PubMedCrossRefGoogle Scholar
  66. 66.
    Vermeulen H, De Doncker E, Watillon M (1973) The Mac Keever patellar prosthesis in femoro-patellar arthrosis. Acta Orthop Belg 39:79–90PubMedGoogle Scholar
  67. 67.
    Walls RJ, Eldridge JD, Mulhall KJ (2007) Patellofemoral arthroplasty: evolving indications, technique, and applications in younger patients. Semin Arthro 18:156–161CrossRefGoogle Scholar
  68. 68.
    Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRefGoogle Scholar
  69. 69.
    Witjes S, Van den Broek C, Koeter S, Van Loon C (2009) Dislocation of the mobile bearing component of a patellofemoral arthroplasty: a report of two cases. Acta Orthop Belg 75:411–416PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Sébastien Lustig
    • 1
  • Robert A. Magnussen
    • 2
  • Diane L. Dahm
    • 3
  • David Parker
    • 1
  1. 1.Sydney Orthopaedic Research InstituteChatswoodAustralia
  2. 2.Department of Orthopaedic SurgeryThe Ohio State University Medical CenterColumbusUSA
  3. 3.Department of Orthopedic SurgeryMayo ClinicRochesterUSA

Personalised recommendations