Preoperative patellofemoral anatomy affects failure rate after isolated patellofemoral inlay arthroplasty

Feucht, Matthias J.; Lutz, Patricia M.; Ketzer, Conrad; Rupp, Marco C; Cotic, Matthias; Imhoff, Andreas B.; Pogorzelski, Jonas

doi:10.1007/s00402-020-03651-9

Cited by 16 publications

(8 citation statements)

References 55 publications

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“…When discussing WOMAC, seven studies state that both inlay and onlay designs yield improved postoperative scores [1, 16, 17, 22, 23, 32, 40]. Feucht et al also directly compared WOMAC scores, between onlay and inlay designs at a median follow‐up of two years.…”

Section: Resultsmentioning

confidence: 99%

Patellofemoral arthroplasty with onlay prosthesis leads to higher rates of osteoarthritis progression than inlay design implants: a systematic review

Sava

Neopoulos

Leica

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this study was to report the clinical and functional outcomes, complication rates, implant survivorship and the progression of tibiofemoral osteoarthritis (OA), after new inlay or onlay patellofemoral arthroplasty (PFA), for isolated patellofemoral OA. Comparison of different implant types and models, where it was possible, also represented one of the objectives. Methods A systematic literature search following PRISMA guidelines was conducted on PubMed, Scopus, Embase and Cochrane databases, to identify possible relevant studies, published from the inception of these databases until 11.11.2022. Randomized control trials (RCTs), case series, case control studies and cohort studies, written in English or German, and published in peer-reviewed journals after 2010, were included. Not original studies, case reports, simulation studies, systematic reviews, or studies that included patients who underwent TKA or unicompartmental arthroplasty (UKA) of the medial or lateral compartment of the knee, were excluded. Additionally, only articles that assessed functional and/or clinical outcomes, patient-reported outcomes (PROMs), radiographic progression of OA, complication rates, implant survival rates, pain, as well as conversion to TKA rates in patients treated with PFA, using inlay or onlay trochlea designs, were included. For quality assessment, the Methodological Index for Non-Randomized Studies (MINORS) for non-comparative and comparative clinical intervention studies was used. Results The literature search identified 404 articles. 29 of them met all the inclusion criteria following the selection process. Median MINORS for non-comparative studies value was 12.5 (range 11–14), and for comparative studies 20.1 (range 17–24). In terms of clinical and functional outcomes, no difference between onlay and inlay PFA has been described. Both designs yielded satisfactory results at short, medium and long-term follow-ups. Both designs improved pain postoperatively and no difference between them in terms of postoperative VAS has been noted, although the onlay groups presented a higher preoperative VAS. When comparing the inlay to onlay trochlea designs, the inlay group displayed a lower progression of OA rate. Conclusion There is no difference in functional or clinical outcomes after PFA between the new inlay and the onlay designs, with both presenting an improvement in most of the scores that were used. A higher rate of OA progression was observed in the onlay design group. Level of evidence III.

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Section: Resultsmentioning

confidence: 99%

Patellofemoral arthroplasty with onlay prosthesis leads to higher rates of osteoarthritis progression than inlay design implants: a systematic review

Sava

Neopoulos

Leica

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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“…This is similar to the findings in our study, where 14 (82%) knees with associated osteochondral pathology had an increased sulcus angle > 145 degrees. In addition, PTI < 0.28 is considered pathologic [ 26 ]. In our study, an abnormal PTI was found in 11% of the knees, which can predispose to recurrent dislocations.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Associated Knee Ligament and Chondral Injuries in First-Time Traumatic Patellar Dislocation: A Retrospective Magnetic Resonance Imaging (MRI) -Based Study

Anazor¹,

Evangelou²

2022

Cureus

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First-time acute traumatic patellar dislocation, when managed without a knee magnetic resonance imaging (MRI) scan, may lead to missed diagnoses of important associated knee injuries. The aim of this study was to ascertain the incidence of associated ligamentous and cartilaginous injuries in first-time traumatic patella dislocation. MethodsThis was a five-year retrospective study on patients aged 16-45 who had knee MRI scans showing the characteristic bone bruise patterns seen in traumatic lateral patellar dislocation. Anonymized data from the hospital picture archiving and communication system (PACS) was obtained with each scan reviewed by a consultant radiologist, a fellowship-trained orthopaedic knee specialist, and an orthopaedic registrar or resident. ResultsA total of 200 knee MRI scans were screened. 61 eligible knee MRI scans were included in the study. The patients' ages ranged from 16 to 42 years old, with a mean of 25 years. 73.8% were male. A medial patellofemoral ligament (MPFL) tear or rupture occurred in 58 of 61 knees (95%) with MPFL attenuation in three (5%) injured knees. Meniscal injuries were identified in 5 of 61 knees (8.2%), medial collateral ligament (MCL) injuries in 11 of 61 knees (18%), osteochondral injuries and loose bodies in 17 of 61 knees (27.9%), and anterior cruciate ligament (ACL) injury in one knee (1.6%). ConclusionsThis single-centre MRI-based study has provided information on the incidence of associated chondral and ligamentous injuries in patients with first-time acute traumatic patellar dislocation. This information will be useful for clinicians when counselling patients and will add to the available literature on this injury. An MRI scan should be obtained in cases of suspected first-time traumatic patellar dislocations, especially in active young patients, due to the incidence of other associated traumatic knee lesions that might need surgical treatment and lead to persisting knee symptoms if neglected.

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“…Alternatively, in the setting of patella alta, a PFA design with a longer anterior flange can be selected. It is noted that patients with patella alta are at a higher risk for failure of the PFA [ 14 ].…”

Section: Surgical Techniquementioning

confidence: 99%

Patellofemoral arthroplasty: expert opinion

Hoogervorst

Arendt

2022

J EXP ORTOP

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Isolated patellofemoral osteoarthritis (PFOA) is a common cause of anterior knee pain in patients over the age of 40 years. Patellofemoral arthroplasty (PFA) is an option to address PFAO when the non-operative or joint preserving management has failed.The goals of PFA are to reduce pain and increase function of the knee in a bone and ligament preserving fashion while maintaining or optimizing its kinematics. Over the last decades advances have been made in optimizing implants designs, addressing complications and improving functional and patient reported outcomes. Appropriate patient selection has proven to be imperative. Proper surgical technique and knowledge of pearls and pitfalls is essential.The indications and surgical technique for patellofemoral arthroplasty will be reviewed here.Level of evidence: Therapeutic Level V.

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Preoperative patellofemoral anatomy affects failure rate after isolated patellofemoral inlay arthroplasty

Cited by 16 publications

References 55 publications

Patellofemoral arthroplasty with onlay prosthesis leads to higher rates of osteoarthritis progression than inlay design implants: a systematic review

Patellofemoral arthroplasty with onlay prosthesis leads to higher rates of osteoarthritis progression than inlay design implants: a systematic review

Patterns of Associated Knee Ligament and Chondral Injuries in First-Time Traumatic Patellar Dislocation: A Retrospective Magnetic Resonance Imaging (MRI) -Based Study

Patellofemoral arthroplasty: expert opinion

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