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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High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos, MD, PhD, SPAIN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, 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
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Differences In Pain, Sleep Status And Functional Recovery Between TKA And UKA ePoster Presentation Takeo Mammoto, MD, JAPAN
Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE

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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