Patellofemoral Arthroplasty

Patellofemoral Arthroplasty: A Systematic Review of the Literature

“…All of the included studies specified isolated PFOA as the primary diagnosis and the indication to embark on surgery. There were several studies that were identified in the literature which had good numbers and sound methodology however the primary pre-operative diagnosis was not restricted to PFOA [ 38 , 39 ]. One particular study by Starks [ 28 ] and colleagues reported results of the Avon PFA and give an excellent independent verdict of the prosthesis, however, within their population they included one patient who had had a failed autologous chondrocyte implantation of the patella.…”

Prospective evaluation of anatomic patellofemoral inlay resurfacing: clinical, radiographic, and sports-related results after 24 months

“…Potential advantages of an inlay design prosthesis include less removal of bone, less mechanical patellofemoral complications, increased implant stability, unaltered soft tissue tension and extensor mechanism, and less risk for overstuffing of the patellofemoral joint [9, 14, 49]. However, older inlay designs were associated with higher failure rates compared with onlay designs, because the individual anatomy of the trochlea was not restored [1, 7, 31, 39, 52, 54, 55]. The HemiCAP ® Wave Patellofemoral Resurfacing System uses intraoperative joint surface mapping and implantation of matching, contoured articular inlay components in order to more closely reproduce the geometry of the distal femur.…”

“…Although patellofemoral arthroplasty has been used for more than 30 years [6, 40], it is still considered controversial [32, 36, 39]. Inconsistent results and relatively high failure rates have led to a decline in popularity of patellofemoral arthroplasty in the past [1, 6, 7, 12, 18, 31, 55, 58, 60]. Drawbacks of the implant design, especially of the trochlear component, are believed to be the major reason for failures with early implants [36, 37, 39].…”

Total knee arthroplasty without patellar resurfacing

“…Possible patellar complications following total knee replacement arthroplasty include osteonecrosis, fracture [12, 17, 19-21, 28, 35-39], subluxation [12,29], patellofemoral instability [4, 6-8, 10, 18], rupture of the quadriceps or patellar tendons [3,15,20,28,32], patellar component failure [12,22,23,28,36], soft tissue impingement [7], patellar pain [4,8,9,12,27,31], and malrotation of the femoral or tibial component [2,11,30,39]. The reported rates of these complications have ranged from 1 to 50% when patellar resurfacing is performed [3, 10, 11, 17-21, 25, 26, 30, 34].…”

“…Although some researchers concluded that resurfacing should be performed, others did not recommend its routine implementation [1,3,11,31].…”