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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Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
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
Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up ePoster Presentation Jerre Co De Guzman, MD, PHILIPPINES Munehiro Ogawa, MD, PhD, JAPAN Yusuke Ozaki, MD, JAPAN Yasuhito Tanaka, Prof., JAPAN Yuki Nishimura, MD, JAPAN Maria Elizabeth Mercado, MD, MAS, PHILIPPINES
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
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Lateral Unicompartmental Knee Arthroplasty (UKA) Showed a Lower Risk of Failure Compared to Medial Unicompartmental Knee Arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO) ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Barbara Bordini, Stat, ITALY Stefano Fratini, MD, ITALY Cristina Ancarani, Stat, ITALY Piero Agostinone, MD, ITALY Alberto Grassi, PhD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY

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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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Discussion

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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