Anteromedialization of the Tibial Tubercle for Patellofemoral Arthritis in Patients > 50 Years

Isolated patellofemoral osteoarthritis

“…Operative treatment: Arthroscopy: 2 randomized controlled trials (165 and 168 patients) were included based on indirect evidence (Moseley et al 2002, Kirkley et al 2008)Chondroplasty, resection-arthroplasty, and lateral facetectomy: 1 prospective case series (50 patients) (Becker et al 2008) and 4 retrospective case series (11–63 patients) (Beltran 1987, Yercan et al 2005, Spak and Teitge 2006, Paulos et al 2008)Extensor mechanism alignment and lateral release: 2 prospective case series (35 and 50 patients) (Alemdaroglu et al 2008, Becker et al 2008), 2 retrospective comparative studies (12 and 48 patients) (Weaver et al 1991, Jacquot et al 2004), and 3 retrospective case series (14–50 patients) (Aderinto and Cobb 2002, Kohn et al 2004, Carofino and Fulkerson 2008)Patellectomy: no studies met the inclusion criteriaTotal knee arthroplasty: 2 matched case-control studies (94 and 54 patients) of total knee arthroplasty for isolated patellofemoral osteoarthritis compared with total knee arthroplasty for tri-compartmental osteoarthritis (Laskin and Van Steijn 1999, Meding et al 2007), 1 prospective case series (24 patients) (Parvizi et al 2001), and 3 retrospective case series (25–47 patients) (Mont et al 2002, Dejour et al 2004, Dalury 2005)Patellofemoral arthroplasty: 3 systematic reviews of case series (538–812 patients) (Leadbetter et al 2005, 2006, Becher et al 2008), 5 prospective case series (15–240 patients) (Arnbjornsson and Ryd 1998, Tauro et al 2001, Merchant 2004, Ackroyd and Chir 2005, Ackroyd et al 2007), and 16 retrospective case series (12–65 patients) (Arciero and Toomey 1988, Cartier et al 1990, Argenson et al 1995, Krajca-Radcliffe and Coker 1996, Mertl et al 1997, De Cloedt et al 1999, Fink et al 1999, de Winter et al 2001, Smith et al 2002, Kooijman et al 2003, Board et al 2004, Argenson et al 2005, Cartier et al 2005, Merchant 2005, Sisto and Sarin 2006, Gadeyne et al 2008). …”

“…Extensor mechanism alignment and lateral release: 2 prospective case series (35 and 50 patients) (Alemdaroglu et al 2008, Becker et al 2008), 2 retrospective comparative studies (12 and 48 patients) (Weaver et al 1991, Jacquot et al 2004), and 3 retrospective case series (14–50 patients) (Aderinto and Cobb 2002, Kohn et al 2004, Carofino and Fulkerson 2008)…”

“…Anteromedialization, which translates the contact area medially, results in relief of the lateral facet which could theoretically reduce pain. Retrospective case series evaluating the 2- to 6-year results of anteromedial transfer of the tibial tuberosity combined with lateral retinacular release have demonstrated an improvement in outcome measures with reduced pain (Weaver et al 1991, Kohn et al 2004, Carofino and Fulkerson 2008). Total loss of cartilage or absence of lateralization are contraindications to the Fulkerson procedure (Steimer and Kohn 2007).…”

Isolierter patellofemoraler Gelenkersatz

“…Die Tuberositasosteotomie zur Entlastung der beginnenden patellofemoralen Arthrose, bei der die Tuberositas v. a. anterior und medial verschoben wird, zeigen in der Hand der Erstbeschreiber gute Resultate [5,12,23]. Sie sollte jedoch mit Bedacht angewendet werden, da Komplikationen wie Tibiafraktur, Kompartmentsyndrom und irritierende große Narben mehrfach in der Literatur beschrieben sind.…”

The evaluation and management of cartilage lesions affecting the patellofemoral joint

“…Patients had poor outcomes with medial lesions or central trochlear lesions [29]. In a study by Carofino et al examining the outcome in older active patients (mean age of 55), it was found that 12 of 19 patients had good-to-excellent outcomes [62].…”