Summary: Similar to its unicompartmental counterparts, isolated patellofemoral arthroplasty yields excellent clinical outcomes, though careful attention to patient selection and surgical steps remain important.

Introduction

Patellofemoral arthroplasty remains controversial, primarily due to high failure rates reported with early implants. Recent design changes may improve the reproducibility of surgical technique and consistency of outcomes. The purpose of this study is to evaluate the early results of one of the largest consecutive series to date of PFA with a milling system technique, and factors that may lead to early failure.

Methods

From 2011 to 2018, 250 patellofemoral arthroplasties were performed by a single surgeon for unicompartmental arthritis. Patients had an average age of 71 years, 66 inches in height, and 166 pounds weight. The majority of patients were female (182/250, 73%). Radiographic and clinical evaluations were performed. Followup was performed for minimum 2 years, with average 4.2 years followup.

Results

With the milling technique, there were no technical complications, component placement or sizing deviations, or intraoperative abandonments to TKA. Patellar thickness averaged 20.3mm prior to resection, and 21.7mm after resurfacing. There were 4 lateral releases performed. Knee Society Scores increased from average 78 to 98 (p< 0.05). The impairments leading to low preoperative scores, and also serving as areas of most improvement, were stair climbing and anterior knee pain relief. One patient developed asymptomatic patellar avascular necrosis. Two patients have been converted to TKA. One clinical failure is due to confounding pain from an ipsilateral arthritic hip and lower spine.

Discussion

With careful patient selection, patellofemoral arthroplasty can have excellent short-term results. However, risk for need for conversion to TKA exists regardless of strict inclusion criteria. A history of prior open knee surgery or confounding pain sources can negatively impact outcomes, regardless of a technically successful PFA procedure. Nonetheless, in most patients, with careful attention to 2 particularly important surgical steps, patellofemoral arthroplasty reliably improves stair function and anterior knee pain.

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Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
A Prospective Randomised Study to Compare the Clinical and Radiological Outcomes of Functionally Aligned versus Mechanically Aligned Total Knee Arthroplasty with Robotic Arm Assistance ePoster Presentation Jai Thilak Kailathuvalapil, MS, MCh, FRCS, INDIA Amal Antony Paul, MBBS, INDIA
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA

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"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients

"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients

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"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients

"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients

Introduction

Methods

Results

Discussion

More 2023 ISAKOS Congress Content