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Surgical Treatment of Isolated Patellofemoral Osteoarthritis

  • Original Article
  • Knee
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Isolated patellofemoral osteoarthritis in the healthy middle-aged population is a challenging problem. Fifty-one knees in 50 patients with isolated patellofemoral osteoarthritis were treated by partial lateral facetectomy, lateral release, and medialization of the tibial tubercle. The minimum followup was 7 months (mean, 20.2 months; range, 7–32 months). Preoperative radiographs showed Ahlbäck Grades III and IV lateral patellofemoral joint space narrowing. The mean age of the patients was 60.1 years (range, 46–81 years). The subjective outcome was based on the WOMAC and the McCarroll score. Posteroanterior flexion weightbearing views, lateral views, and 45° axial views were taken. According to the WOMAC score, the scores improved considerably by 2.34 points with respect to pain and by 1.63 points with respect to function. The Insall-Salvati index decreased considerably but still remained in the physiologic range. The majority of these patients experienced improvement in their patellofemoral symptoms. However, the clinical outcome was not better in comparison to other surgical procedures. After the short followup, we would not recommend combined lateral facetectomy, lateral release, and medialization of the tibial tubercle until longer results are available.

Level of Evidence: Level IV Therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, the Otto-von-Guericke University of Magdeburg, Magdeburg, Germany

    Roland Becker MD, PhD, Martin Röpke MD & Anja Krull MD

  2. Centre of Orthopaedics and Traumatology, Hospital of Brandenburg, Hochstrasse 29, 14770, Brandenburg, Germany

    Roland Becker MD, PhD

  3. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Volker Musahl MD

  4. Department of Sports Medicine and Rheumatology, Marienhospital Kaiserswerth, Kaiserswerth, Germany

    Wolfgang Nebelung MD, PhD

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  1. Roland Becker MD, PhD
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  2. Martin Röpke MD
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  3. Anja Krull MD
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  4. Volker Musahl MD
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  5. Wolfgang Nebelung MD, PhD
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Correspondence to Roland Becker MD, PhD.

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Each author certifies that he has no commercial association (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Becker, R., Röpke, M., Krull, A. et al. Surgical Treatment of Isolated Patellofemoral Osteoarthritis. Clin Orthop Relat Res 466, 443–449 (2008). https://doi.org/10.1007/s11999-007-0071-9

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  • DOI: https://doi.org/10.1007/s11999-007-0071-9

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