Early results of patellofemoral inlay resurfacing arthroplasty using the HemiCap Wave prosthesis

Abstract

Background: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre. Methods: From 2010 to 2013, 16 consecutive patients underwent patellofemoral resurfacing procedures using HemiCap Wave (Arthrosurface Inc., Franklin, Massachusetts, USA) for anterior knee pain with confirmed radiologically and/or arthroscopically isolated severe patellofemoral arthrosis. Standardized surgical technique, as recommended by the implant manufacturer, was followed. Outcome measures included range of movement, functional knee scores (Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Short Form-36 (SF-36)), radiographic disease progression, revision rates and complications. Results: Eight men and eight women underwent patellofemoral HemiCap Wave resurfacing, with an average age of 63 years (range: 46-83). Average follow-up was 24.1 months (6-34). Overall, post-operative scores were excellent. There was a statistically significant improvement in the post-operative OKS, KOOS and SF-36 scores (p < 0.01). One patient had radiological disease progression. One patient underwent revision for deep infection. Two other minor complications were observed and treated conservatively. Conclusions: The HemiCap Wave patellofemoral resurfacing prosthesis has excellent early results in terms of functional outcomes, radiological outcomes and low complication rates. At the very least, early results show that the HemiCap Wave is comparable to more established onlay prostheses. The HemiCap Wave thus provides a safe and effective surgical option in the treatment of isolated patellofemoral osteoarthritis in selected patients.

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

“…Ten papers met the criteria that we had posed: four of them (40%) dealt with the HemiCAP focal femoral condyle resurfacing prosthesis, 3 , 14 , 17 , 18 four (40%) explored the clinical use of the HemiCAP-Wave® implant for the treatment of trochlear cartilage lesions, 15-21 one study (10%) dealt with both these implants (HemiCAP focal and HemiCAP-Wave® implant) 16 and one study (10%) with the UniCAP implant for femoral condyle cartilage defects ( Table 1 ). 13-21 …”

“…In the current review, we found 5 clinical trials which investigated the HemiCap ® Wave prosthesis. 15-21 The total number of patients involved were 154. The mean follow- up ranged from two years to seven years, while the complications’ rate was 9.7% (15 patients).…”

“…Overall, almost all the authors (80%) agreed that the use of the HemiCAPWave ® prosthesis was clinically effective. 15 , 16 , 19 , 21 …”

“…Patel et al in another clinical trial with small number of patients (16 patients) demonstrated excellent early results with the HemiCAP ® Wave prosthesis. 15 …”

“… 14 The HemiCAP implant (HemiCAP_ Focal Femoral Condyle Resurfacing Prosthesis, Arthrosurface Inc., Franklin, MA, USA) for femoral and patellofemoral resurfacing for treatment of cartilage lesions was introduced in 2003 and 2009 respectively. 15 , 16 The femoral resurfacing for large cartilage lesions with the anatomic UniCAP implant (UniCAP® Focal Femoral Condyle Resurfacing Prosthesis, Arthrosurface Inc., Franklin, MA, USA) was introduced in 2006. 16 We performed a review of the literature concerning the studies that have been published about the application of partial resurfacing for the treatment of focal femoral and trochlear full-thickness cartilage defects.…”