Patellofemoral Arthroplasty: A Systematic Review of the Literature

Abstract

Identification and management of patients with isolated patellofemoral osteoarthritis are challenging. Many of these patients present at a young age and it is important to distinguish degenerative change in the patellofemoral articulation from the other various causes of anterior knee pain. Once the diagnosis of isolated patellofemoral arthrosis has been made non-operative and conservative surgical techniques should be exhausted fully before prosthetic arthroplasty is considered. This review focuses on the use of arthroplasty for isolated patellofemoral arthrosis, in particular comparing the use of total knee against selective patellofemoral joint replacements.

A matched-pair comparison of inlay and onlay trochlear designs for patellofemoral arthroplasty: no differences in clinical outcome but less progression of osteoarthritis with inlay designs

“…Progression of tibiofemoral OA is the most common reason for the failure of PFA using modern prosthetic designs [13,25,44]. An interesting finding of the present study was that none of the patients with an inlay component showed progression of tibiofemoral OA, whereas more than half of the patients in the inlay group demonstrated progression of medial and/or lateral tibiofemoral OA.…”

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

“…No significant progression of tibiofemoral OA or significant changes in patellar height were observed. To date, most trochlear implants can be considered as onlay designs or anterior cut prosthesis, respectively [39,54,59]. These implants are based on the trochlear cuts of a total knee arthroplasty, replacing the entire anterior trochlear surface [39].…”

Isolated Patellofemoral Joint Arthroplasty: Can Preoperative Bone Scans Predict Survivorship?

“…Dahm et al [12] demonstrated that PFA has comparable clinical outcomes to TKA but with less blood loss and a shorter hospital stay. Tarassoli et al [13] noted in a systematic review that PFA has the advantage of being a less invasive operation, with quicker postoperative recovery and preservation of bone stock, with the option to convert to TKA at a later time.…”

“…Despite the potential advantages of isolated PFA, the initial results of the first-generation PFA implants were not favorable, with high failure rates primarily due to mechanical failure [14e17]. McKeever originally proposed a design allowing for a Vitallium shell to replace the patella surface [13,18]. This design eventually lost favor due to concerns of the accelerated wear of the femoral trochlea cartilage.…”