Ming Han Lincoln Liow1, Graham Seow-Hng Goh2, Darren Keng-Jin Tay1, Shi-Lu Chia1, Ngai-Nung Lo1, Seng-Jin Yeo1. 1. Department of Orthopedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4 169865, Singapore. 2. Department of Orthopedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4 169865, Singapore. Electronic address: goh.graham@gmail.com.
Abstract
PURPOSE: Proper indications and patient selection are of paramount importance in patellofemoral arthroplasty (PFA). Although factors predicting outcomes in total knee arthroplasty (TKA) have been studied, there are no such studies for modern PFA. This retrospective study reports the midterm clinical and radiological outcomes and survivorship of PFA, investigating the risk factors associated with poorer outcomes and higher revision rates. METHODS: Fifty-one patients (51 knees) with isolated patellofemoral arthritis underwent PFA with a second-generation implant. The mean follow-up duration was 4.1 years (range, 2.2 to 6.1). The cohort was stratified into obese (body mass index (BMI)≥30 kg/m(2), n=16), overweight (BMI 25 to 29.9 kg/m(2), n=20) and control (BMI 18.5 to 24.9 kg/m(2), n=15) groups. The same cohort was stratified based on the presence (n=11) or absence (n=40) of trochlear dysplasia (TD). RESULTS: The mean Knee Society objective and function scores, the Melbourne Knee score and the Physical Component Score of Short Form 36 improved significantly. Obesity was associated with no significant improvement in the Melbourne Knee score and the Knee Society function score (p>0.05), a higher incidence of radiographic outliers and lower patient satisfaction. There was no significant difference in outcomes between the TD and non-TD groups at two years (p>0.05), with a survivorship of 92.2%. Three revisions for progression of tibiofemoral osteoarthritis were noted in the non-TD and obese or overweight groups. CONCLUSIONS: Patients with obesity and the absence of TD are at a potentially higher risk of revision surgery to TKA, and they should be counselled that PFA may represent a 'bridging' procedure. LEVEL OF EVIDENCE: III.
PURPOSE: Proper indications and patient selection are of paramount importance in patellofemoral arthroplasty (PFA). Although factors predicting outcomes in total knee arthroplasty (TKA) have been studied, there are no such studies for modern PFA. This retrospective study reports the midterm clinical and radiological outcomes and survivorship of PFA, investigating the risk factors associated with poorer outcomes and higher revision rates. METHODS: Fifty-one patients (51 knees) with isolated patellofemoral arthritis underwent PFA with a second-generation implant. The mean follow-up duration was 4.1 years (range, 2.2 to 6.1). The cohort was stratified into obese (body mass index (BMI)≥30 kg/m(2), n=16), overweight (BMI 25 to 29.9 kg/m(2), n=20) and control (BMI 18.5 to 24.9 kg/m(2), n=15) groups. The same cohort was stratified based on the presence (n=11) or absence (n=40) of trochlear dysplasia (TD). RESULTS: The mean Knee Society objective and function scores, the Melbourne Knee score and the Physical Component Score of Short Form 36 improved significantly. Obesity was associated with no significant improvement in the Melbourne Knee score and the Knee Society function score (p>0.05), a higher incidence of radiographic outliers and lower patient satisfaction. There was no significant difference in outcomes between the TD and non-TD groups at two years (p>0.05), with a survivorship of 92.2%. Three revisions for progression of tibiofemoral osteoarthritis were noted in the non-TD and obese or overweight groups. CONCLUSIONS:Patients with obesity and the absence of TD are at a potentially higher risk of revision surgery to TKA, and they should be counselled that PFA may represent a 'bridging' procedure. LEVEL OF EVIDENCE: III.
Authors: Yong Zhi Khow; Ming Han Lincoln Liow; Merrill Lee; Jerry Yongqiang Chen; Ngai Nung Lo; Seng Jin Yeo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-01-29 Impact factor: 4.342
Authors: Matthias J Feucht; Patricia M Lutz; Conrad Ketzer; Marco C Rupp; Matthias Cotic; Andreas B Imhoff; Jonas Pogorzelski Journal: Arch Orthop Trauma Surg Date: 2020-10-30 Impact factor: 3.067
Authors: Andreas B Imhoff; Eva Bartsch; Christoph Becher; Peter Behrens; Gerrit Bode; Matthias Cotic; Theresa Diermeier; Holger Falk; Matthias J Feucht; Ulrich Haupt; Stefan Hinterwimmer; Johannes Holz; René Hutter; René Kaiser; Tobias Knoblauch; Wolfgang Nebelung; Philipp Niemeyer; Turlough O'Donnel; Geert Pagenstert; Thilo Patzer; Tim Rose; Marco C Rupp; Thomas Tischer; Arne J Venjakob; Stephan Vogt; Jonas Pogorzelski Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-04-02 Impact factor: 4.342