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Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis—a systematic review

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Abstract

Purpose

Patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA) are accepted treatments for end-stage isolated patellofemoral osteoarthritis (PFOA). However, complications and re-operations have historically differed between the two procedures. We performed a systematic review to report on the re-operation rates between TKA and modern PFA for isolated PFOA.

Methods

Systematically identified publications reporting on patients that underwent either TKA or modern PFA for isolated PFOA were reviewed. Meta-analysis software was used to screen potential articles with at least one year follow-up that detailed reasons for re-operation. Data was extracted and analyzed for all re-operations. Survival of the implant was used as the primary outcome; return to the operating room (OR) for any reason was used as a secondary outcome.

Results

The weighted rate of either conversion or revision arthroplasty in the PFA group and the TKA group was 6.34 and 0.11, respectively. The weighted rate of return to the OR for bony and soft tissue procedures was 1.06 and 0.79, respectively. The weighted rate of manipulation under anaesthesia (MUA) was 0.32 and 1.23, respectively.

Conclusion

Patients who undergo PFA may be more likely to return to the operating room for conversion to TKA and/or revision surgery than those who undergo TKA.

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Acknowledgments

We are grateful to Kara Fields for her assistance in the statistical analysis.

Funding

This study was partially funded by the generous donation of Mr. Glenn Bergenfield, the Sidney Milton and Leoma Simon Foundation, and by Ms. Elizabeth Kim.

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Authors and Affiliations

  1. Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, 10021, USA

    Colin Y. L. Woon, Alexander B. Christ, Kate Shanaghan & Alejandro Gonzalez Della Valle

  2. Kim Barrett Memorial Library, Hospital for Special Surgery, New York, NY, USA

    Rie Goto

  3. Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA

    Beth E. Shubin Stein

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  1. Colin Y. L. Woon
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Correspondence to Alejandro Gonzalez Della Valle.

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Woon, C.Y.L., Christ, A.B., Goto, R. et al. Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis—a systematic review. International Orthopaedics (SICOT) 43, 1611–1620 (2019). https://doi.org/10.1007/s00264-018-04280-z

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