Correction of Patellofemoral Malalignment With Patellofemoral Arthroplasty

Valoroso, Marco; Saffarini, Mo; Barbera, Giuseppe La; Toanen, Cécile; Hannink, Gerjon; Nover, Luca; Dejour, David

doi:10.1016/j.arth.2017.06.048

Cited by 21 publications

(17 citation statements)

References 24 publications

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“…Correlational studies noted better outcomes in IPA patients with subluxation and dislocation after PFA, which were commonly associated with trochlear dysplasia [25,26]. Marco Valoroso et al [27] pointed out that PFA improves patellofemoral congruence by correcting trochlear dysplasia and standardizing radiological measurements as patellar tilt and TT-TG. However, for IPA patients, there has been at least a 5% rate of patellar subluxation after PFA at a long-term follow-up [28].…”

Section: Discussionmentioning

confidence: 99%

“…The normal TT-TG distance measured on computed tomography (CT) scans is between 10 and 20 mm and more than 20 mm is the operative indication of tibial tubercle transfer (TTT) [18]. For elderly patients, the surgical "gold standard" for IPA has traditionally been patellofemoral arthroplasty (PFA), which literature has demonstrated to provide good long-term outcomes [25][26][27]. However, for IPA patients, there has been at least a 5% rate of patellar subluxation after PFA at a long-term follow-up [28].…”

Section: Introductionmentioning

confidence: 99%

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Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance

Dong

Zhao

et al. 2021

Preprint

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BackgroundThe objective of present study was to investigate the operative effect of patellofemoral arthroplasty combined with the tibial tubercle transfer for isolated patellofemoral arthritis patients with an increased tibial tuberosity-trochlear groove distance (>20mm). MethodsA prospective study was performed between November 2012 and December 2017. Finally, thirty-six cases, with a mean age of 61.1 ± 7.3 years, were admitted to our study. A total of 17 patients underwent patellofemoral arthroplasty combined with tibial tubercle transfer, and 19 patients underwent patellofemoral arthroplasty only. All eligible patients had CT scans preoperatively and at 12 months follow-up, to assess the stability of the patellofemoral joint on axial slices. In addition, the demographic and clinical features of all the patients were asked. Knee balance was assessed with the single leg stance test and timed get up and go, and functionality was evaluated with stair climbing test and the Western Ontario and McMaster Universities Osteoarthritis Index score. (P>0.05) ResultsPreoperatively, the data regarding the knee balance and functionality were not significantly different between the two Groups (P>0.05). Many measurements showed significant differences between the two groups at the last follow-up. Significant differences were seen in well-known measurements such as the SLST (Group I, 28.9 s (SD 7.5); Group II, 20.3 s (SD 5.9); p < 0.001), TGUG (Group I, 13.4 s (SD 3.2); Group II, 16.8 s (SD 3.1); p < 0.001), and SCT (Group I, 18.6 s (SD 6.8); Group II, 24.5 s (SD 8.7); p < 0.001). Additionally, the median WOMAC score was improved from 62.7 (SD 11.2) preoperatively to 25.7 (SD 8.2) one year postoperatively in Group I and from 64.1 (SD 10.7) to 36.2 (SD 9.7) in Group II, which were also significantly different between the groups. ConclusionsFor such special IPA patients with an increased TT-TG (>20mm), the combined operation of PFA combined with TTT can better restore the involutional relationship of patellofemoral joint and further improve the balance and function of knee joint.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance

Dong

Zhao

et al. 2021

Preprint

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“… 30 The trochlear groove is essential for correct patellar tracking during movement. 31 According to Chawla et al , 32 recent improvements in rates of implant survival have made PFA an economically beneficial joint-preserving procedure in younger patients, delaying TKA until implant failure or tibiofemoral osteoarthritis (OA) progression. Nevertheless, due to the variable outcomes, at present, PFA remains a controversial treatment for advanced patellofemoral OA.…”

Section: Discussionmentioning

confidence: 99%

The clinical outcome of the different HemiCAP and UniCAP knee implants: A systematic and comprehensive review

Malahias¹,

Chytas²,

Thorey³

2018

Orthop Rev (Pavia)

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The focal metallic cartilage resurfacing is a surgical method that offers an appropriate step between the biological techniques and arthroplasty in middle-aged patients with full-thickness cartilage defects. The advantages of this technique are that it addresses the defect, respects healthy tissues and provides stability and contoured surface similar to a full arthroplasty. A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (MM and DC) independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews (CDSR). These databases were searched for the terms hemicap knee implant and unicap knee implant and knee focal metallic implant. From the initial 21 studies that were evaluated, 10 were eligible for analysis. Considering both the HemiCAP focal implant and the HemiCap® Wave patellofemoral prosthesis, we found a lack of mid- to long-term clinical outcomes in well-designed prospective clinical studies. No Level I or II studies were found, while the limited number of patients who were included undermines the overall clinical results of these studies. The progression of osteoarthritis, the persisting pain and the subsequent high revision or failure rates in the limited available studies with long-term follow-up, seem to be the major drawbacks of these partial resurfacing techniques. Utilization of partial resurfacing for femoral or patellofemoral compartments results in good short-term outcome for middle-aged patients as a step between biological technique and total knee arthroplasty. The surgeon should be cognizant and also notify the patient of the high failure rates that are reported in the literature in mid- to longterm follow-up and ultimately, the decision to perform partial resurfacing should be taken by both the patient and the orthopedic surgeon.

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“…45 Furthermore, the depth of the patellar resection cannot be considered in isolation, and an appreciation of the corresponding femoral resection is required. 46…”

Section: Preparation Of the Patellamentioning

confidence: 99%

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

Roussot

Haddad

2019

EFORT Open Reviews

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Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis. The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome. New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique. Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs. Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA. Cite this article: EFORT Open Rev 2019;4:503-512. DOI: 10.1302/2058-5241.4.180094

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Correction of Patellofemoral Malalignment With Patellofemoral Arthroplasty

Cited by 21 publications

References 24 publications

Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance

Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance

The clinical outcome of the different HemiCAP and UniCAP knee implants: A systematic and comprehensive review

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

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